HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: l
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34952
Phone:(772)462-15S3 Fax:(772)462-x57$ Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line /PMIC4
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Address: UOti dal 34A R
Legal Description:
Property Tax ID#. 11�L5 y 710/— 0092 + � Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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lona wor o e Orme un ert ispermit—c ec a appy:
_HVAC _Shutters E]Windows/Doors
Gas Tank Gas Piping
Electric Q Plumbing []Sprinklers 0 Generator Roof
Total Sq.Ft of Construction: �i SFt,of First Floor:
Cost of Construction:$ S0137 dp Utilities:-Sewer Septic Building Height:
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Name F`d!' C Name: JOHN V LAN02L
Address '159 __ 566 [` V ����A _ Company: SF�COAST A/C
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City: RX itT r�tl _ Stater Address: 2601 INDUSTRIAL AVEC 3
Zip Code: _� `��� Fax:t� City: FT PIERCE State:EI-
Phone No. 779, Zip Code: $4946 Fax: 466.3053
E-Mail- Phone No. 466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEACOASTAIR@AOI 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.
SURFLEM. �ITAL;C.ONSTRU.CTI.QN
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: __-- State: City: State:
Zip: Phone: ' Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City. -- —
zip: Phone: Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting aHermit 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,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWN :Your failure to Record a Notice of Commencement may result in your paying twice for
improvements toy r property. A Notice of Commencement must be recorde and posted on the jobsite
before the first in ection. If ya intend to obtain financing,consult with len or an attorney before
commencing woMor recordingftur Rotice of Commencement.
V/W V/. &// s
_Signature Owner/Lessee/ ent Signature of Con ctor/License der
STAT F FLORIDA STATE OF FLORIDA
GO OF STLUCIE COUNTY OF�WCiE
The fo oing instrum t was acknowled a efore me The for oing instrume t was acknowledged before me
this day of MOj/ . 20 �by this day of a 20 L:� by
JOHN V LANGELl JOHN v LANGEL
(Na erson acknowl g) (Nam erson acknowl g)
Igna Ic- tate o on a f Florida)
Personally Known X Produced Identification Personal wn X 0 Produced Identifcation
Type of identification Produced Type of Identification Pr d
Commission No. (Seal) Commission No. (Seal)
It KAY LAN
��� •K►FY P68\.
A�..nµY PUB(•l fS
£� MY CQMMISSION#FF148072
Revised � } MY GQMMISSION#Fps 2018 z.,
u ust 3o, �?o;�a?%f EXPIRES August 30,2018
ARES A 9 _
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REVIEWS6'1; ZO—NI NGSUPERVISOR PLANS VEGETATION SEATURTL ROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIAIS