HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �b �a 5 Permit Number:
RECEI'.'^D OCT 221015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
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Address: 11167 LANDS END CHASE
Legal Description:
Property Tax 1D#, 3321-803-0018-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_--__.--_ -.. Back: Right Side: Left Side:
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7OUit—ionaiwori(toi).evertormectunder this permit—cli all appy:
121HVAC Gas Tank Das Piping _Shutters Windows/Doors
Electric Plumbing E]Sprinklers Generator ElRoof
Total Sq, Ft of Construction: S Ft,of First Floor:
Cost of Construction!$ 5164.00 Utilities: Sewer Septic Building Height,
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Name PAULENE LEASE Name: JOHN V LANGEL
Address:11167 LANDS END CHASE Company: SEA COAST A/C
City: PT ST LUCIE State:_ Address: 2601 INDUSTRIAL AVE 3
Zip Code: 34966 Fax: City: FT PIERCE State:FL
Phone No,465-0679 Zip Code: 34946 Fax: 466-3053
E-Mail: Phone No, 466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEACCASTAIR@AOL.COM
from the Owner listed above) State or County License: CAC016446
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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N LA, 0.
DESIG NERANG I NEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State; City; SLate;
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER. Not Applicable BONDING COMPANY; Not Applicable
Name. Name:
Address: Address:
City: City,
Zip: Phone; Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and.covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review.your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements/o your -
pro rty, A Notice of Commencement must be recVded and posted on ejob5ite
before the fir inspectiollifyou intend to obtain financing, consult witender or a attorne fore
commencingCrk or re ur Notice of Commencement.
Signa 'of Owner/L ee/Agent Signature o' ontractor/Lice Holder
STA OF FLORID STATE7F FLORIDA
TY
CC) TY OF ST LUCIE; COUN YOFFSTLUCILI
The Ficioing ins "u acknowl�ftd before me The forgoing Instrument was acknowledged e
this " day of 20 -
thk�:X itna 5 acknowledged
L-m
A day of 12k by
JOHN r.F;L;l JOHN V LANGEL
m of person ac cn e (Name of onacknowledging
u lic-Sta (Signa of N ublic-
Personall Kno n X OR cluced identification Person Known x OR rod d Identification
Type of identification Produced Type identification Prod ced,
Commission No. —.Zl
I (Seal)
4�jtY A6" TRACY
&AV tlt-AAMISSION#Frl 48079 TRACY KAY LANcar=L
1%-�, Mr
ION#FF148072
ii�FIRFES August 30, Klx�- -
41 EXPIRES Auquist 30,_o 18
Revised 07/1 rldallomrysemre--�m
9 afttalysery
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P,r,,�,all , X
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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