HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
Building Permit Application NOV 16 2015
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 3498,2
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �d
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Address: X16 5' —
Legal Description:
Property Tax ID#: `J10.9 ®Ll ^ 00,15;. Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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i na war to e e orme un er this permit t c pec a appy:
_HVAC Gas Tank Gas Piping _Shutters Windows/boors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 5q. Ft.of First Floor:
Cost of Construction:$, �y5 .DGS _ _ utilities: Sewer 1 rJSeptic Building Height:
OWNE : . ,., . . ....,,.. ...• RQ
Name 1i Name: JOHN V LANGEL
LfhlAddres : `5 & Y ✓ Company: SEA COAST AIC
City: State: • Address: 2601 INDUSTRIAL AVE 3
Zip Code: Fax: City: PT PIERCE State:FL
Phone No.-;2 cm— 'W—g�U _ 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: TLSEACOASTAIR@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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DESIGNER 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 1 will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and 5t.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 nonresidential use
WARNING TO OWNE Your failure to Record a Notice of Commencement may resul in your paying twice for
improvements to yo property,A Notice of Commencement must be recorde Ind posted on the jobsite
before the first insp tion. if you tend to obtain financing,consult with len r or an att ney before
commencingwork recordin our Notige of Commencement.
S_
_Signat/OFS�T
ner/Lessee/ nt Signature of Con ctor/License Ho er
STATE RIDA STAT~OF F ORIDA
COUNUuc.s COUNTY OFsr�uc�e
The fo oing instrument cknowledge efore me The forgoing instrument was acknowledged before me
thls day of wa , 20 by this IL day of s(n V 20 )�' by
JOHN [tEl� JOHN v LANOEL
{Na e f rson ac ow le ng) (Name o e s cknow ledSing)
n re f N a (Signal - a o Ida)
Per anally own x OR produced Identification Person y Know x OR P od ed Identification
Type o entification Produced Type o cation produced
Commission No. _ (Seal) Commission No. (Seal)
Revised 07/1 , 'CRAO'd KAY �p�F14eo72 4�p;Yp
:r°•' � COMM13StO p18 TRACY KAY L.ANGEL
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REVIEWS °'{tsa Z t -SUPERVISOR PLANS Iao s� A�IPri�doN t� �E MANGROVE
' EVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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