HomeMy WebLinkAboutBuilding Permit Application 11/05/2015 15:13 7724662417 SEACOAST SHEET METAL PAGE 02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: }1 `��:�'S Permit Number:
m
BUilding Permit Application
Planning and Development 5ervlce5
Building and Code Regulation Division
2300 Virginia Avenue,fort Pierce FL 3498.E
Phone:(777.)4.62-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line qC,
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. EMl?.ROVE•ME•NT`L� ",.'`',;•`
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Address: lit
Legal Description:
Property Tax ID#• 70 f }01�` _ Lot No.—
Site Pian Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
I]STA
'ILD'DEClIf'TI0N OF
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TRU,GTCONI ON'>f N,.( R1
t` iaNz,
itl a worttobenarrormecl under tis permit—cneCK a appy:
_HVAC Gas Tank []Gas Piping _Shutters o Windows/Doors
Electric Plumbing Sprinklers 0 Generator O Roof
Total Sq. Ft of Construction: r� 5q. Ft.of First Floor:
Cost of Construction:$ 1 1zco Utilities:lJ Sewer Septic Building Height:
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..O1NNE> ''.tE E '
Name •6n f)P5 Le Name: JOHN V LANGEL _ —
Address: q4--5WWilA DT to _ Company; SEACOAST A/C
City: h06 ffeP CState:_ Address: 2601 INDUSTRIAL AVE 3
Zip Code 111Fax: _ _ City: FT PIERCE T State:FL
Phone No. W1— Zip Code: 34946 Fax: 466-3053
E-Mail: Phone No. 466-2400
Fill in fee simple Titie Holder on next page(if different E,Mail: TLSEACOASTAIR@AOL.COM
from the Owner listed above) State or County License: CAGO16446
If value of construction is$2500 er more,a RECORDED Notice of Commencement is required,
11/05/2015 15:13 7724662417 SEACOAST SHEET METAL PAGE 03
�Ui�PI E.mENTAL:CQfVS 'I [1CT�: NII;EIV,LA.UIi INFOR:(VIA`f],
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6 USi_GN 9R/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: _ _ Name:
Address; Address:
City: State: City: —State:
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 holder to 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,swim ing pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWN :Your fai re to Record a Notice of Commencement may result in your paying twice for
improvements to y r prope .A Notice of Commencement must be recon ed and posted on the jobsite
before the first in ection. if au i nd to obtain financing,consult with I der or%attorney before
commencingwo or re or n Notice of Commencement.
I Vv s
_Signature Owner/L /Agent Signature of ntractor/Llc se Hol r
STATE FLORIDA STATE 0 FLORIDA
COUNTY OFsrLucle COUNTY OFsrLucle
The forgoing instrurn jt was acknowledged�efore me The f going instrum yl�vyzs acknowledgedc�efore me
this ' day of 20 _by this_day of_ /jr y 20 1J by
JOHN V EL JOHN V LANGEL
of person acknowle } (Name of p o mowlIs ging)
o
Ignature otary Pub' i5la—teof Florida) (Signature Notary -State of or a}
Perso ly Kn n x Produced Identification Personally Kno x OR Produc Identification
Type Ificat!on Produced Type of Identl n Produced
Commission No. =
Commission No. (Seal)
TRAM KAY
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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INITIALS