HomeMy WebLinkAboutBuilding Permit Application 7728718803 p2
Miranda Plumbing&AC
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: V Permit N umber:
RECEI 0 NOV 13 2015
Building Permit AppliCatiod
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce.FL 34982
Phone:(771)462-1553 Fax:(772)462-15178 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
Address, 7:4- P akornnc
Legal Description.,
Property Tax ID#A�� Lot No.
Site Plan Name.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETALE0 DESCRIPTION OF WORK:' ... .
HID
Addition r t7 is-perm it- pplv�
VAC Gas Tank DGas Piping 71hutters Winclows/Doors
Electric Plumbing OSprinklers 11 Generator R o of
Total Sq.Ft of Construction-, So. Ft.of First Floprz
Costof Construction: Septic Building Height;
Utilities:L7 Sewer
OWNE'AILESSEE: CONTRACTOR:
k to b n
Companyk QA)
Zip Cod Fax: Clty'pl
A - MM1'&C(:-!C*WAhoneNo*,
Fill in JWTpe Title Holder on next page(If different E-M' ail-n cmah,6
from the Owner listed above) State or County License:L'
If va ue of construction Is$250D or more,a RECORDED Notice of Commencement is required,
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Miranda Plumbing&AC 7728710863 p,3
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St1PPLEi1IlENTi4l` G
TR,; .11 Nw;LILN[A1N•1Nl' -
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DESIGNED/ENGINEER Not Applicable (MORTGAGE COMPANY: Not Applicable
Name: Name: --
'Address: Address:
City: I State: City: State:
Zip. Pho e' Zip: Phone:
FEE SIMPLE TITLE HOLbER: —Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: '
i Address:
City: ) City:
Zip: Phohe• Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated,
I certify that no work or in�tallatlon has commenced prior to the issuance of a permit.
St,LucleCounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with t plicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult w�twyour Home Owners Association and review your deed for any restrictions which may apply.
in consideration of the gra,ting 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 OWNS :Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to you property, A Notice of Commencement must be recorded and posted on the jobsite
beforerfi e first inspec ion. If you intend to obtain financing,consult with lender or an attorney before
conithenting work or recording vour Notice of Commencemen ,
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Signature of Owner/Agent/Lessee Signa rem ontractorlUcense Holder
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STATE OF FLO t A }} STATE OF FL(J!1 A
COUNTY OF ��1 i t COUNTY OF
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The instrument wa ackn wiled ed before me , The r oing instr ent was acknowledged before me
this may of 2t]'r by ?,� this day of 210_0 by
at £' Z f Win'
;(NZ/amperson'acknowld,dging) y ro (Name o person ackn wledging) y x coo
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(Signature of Notary Publi -State of Florida) o c (SIgYature of Notary Public State of Florida)
V;to�
Personally i4nown' OR Produced Identi€ication Personally Known OR Produced Identification
Type of Identification Proc uced Type of Identification Produced
Commission No. (Seal) Commission NoLL (Seal)
Revised 07/1512014
REVIEWS FROND ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETE[ i