HomeMy WebLinkAboutBuilding Permit Application Nov 19 15 03:04p p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I I ( I
•
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine
PROPOSED IMPROVEMENT
MPROVEMENT LOCATION: -T
Address:CL950 3. bCfL I DY -4 u09
Legal Description:MK(=( R() W t OI 11Qb�D 398A—r1btp)
Property Tax ID 11p?,-WL�S- DOD-q Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
HVAC OWq-e W .t) a 3.5 -on FY-Si CornpF j 11ia, cf
3wycc yl � pldN�lp 13 SEER
CONSTRUCTION INFORMATION:
F Additional work to a orme un er tFjs perrnrt—c ec a app y:
LY(HVAC L J Gas Tank Gas Piping _Shutters n Windows Doors
Electric F] Plumbing Sprinklers Generator EIRoof
Total Sq.Ft of Construction:t�()� pc oOaXk� 6 Ft.c First Floor:
Cost of Construction:$ 51 900,6z) Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name:'6mandou
�"
AddressM}� �.af 4 ))d�_ Company:sm1c.sw A�� ewdy oOOQQ AW �
City: 2a ) �r�� Stater Address: Y11Go D,I lW MCI-
Zip Code: Fax: City:_01 010D Q State:
Phone No. )Iq' 1/ Zip Code:311&� Fax:L�515(95-d RJLP
E-Mail: Phone No.IT19--r,rio- b3
Fill in fee simple Title Holder on next page(if different E-Mail:ifli&SM_a,8 QYC00` yy&bra ,p
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Nov 19 15 03:04p p.3
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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-,o the issuance of a permit.
St.Lucie County makes no representation that is granting a permit wiii authorize the permit holder to build the subject structure
which is in conflictwith 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!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 to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
—Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA „ccam� STATE OF FLORIDA
COUNTY OF IJl�CL1�1G«i COUNTY OF D1'GI, l
The forgoing instru(rent was acknowledged before me The forgoing instrument was acknowledged before me
this ay of 1VOV�Xri�O��, 20 L6 by this�aQ�tgay of 20 1GJ by
"_Rok� Nprjl�e__�
(Name of person acknowledging) (Name of person acknowledging)
' t r , 4A /�
ignature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
Personally Known il OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Seal Commission No. (Seal)
�” Notary Public State of Ponda "&- lidwari o
'7 My commission FF 096142 Catherine Harris
Revised 07115/2014 nor Expires 02125/201a � qty Commission FF 096142
o+ Expires 0=500118
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITJALS
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