HomeMy WebLinkAboutDOC112315-11232015113404ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; . Permit Number. Jai I — 00'5�
11 *W Building Permit Application
Planning and Development services
Building and Code Regulation, Division
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Aiiq,-4 III
Address: IZ7
Legal Description:
Property Tax ID #: JLIaS -7191- 009q 000-0 Lot No.
Site plan Marne: Block No.
Project Name:
Setbacks Front_ Back:_ Right Side:_ Left Side:
ti Xt f,0rTi1ice -- 6- *n ys' 5eei` (aka
I_HVAC Gas - Tank ---- -- []Ga - 5 Piping O_Shutters ElWindows/Doors
Electric QPIumbIng OSprinklers 11 Generator EI Roof
Total Sq. Ft of Construction: SFt' of First Floor:
Cost of Construction: $ Utilities: Sewer USeptic Building Height:
if value of construction is $2500 or more, a RECORDED Notice at
requirea.
Name rjarwn Po (a
Name: JOHN V LANGPL
Address; tw")�vdd f3a'A'; f)�
Company; SEACOAST A/C
City: it —State. -F—/—
Zip Code: ff�q Fax:
Phone No. 77A.-
E -Mail-
Fill in fee sim , pie Title Holder an next page (if different
from the Owner listed above)
Address: 2601 INDUSTRIAL AVE 3
City: FT -PIERCE State;Fl.
Zip Code: 54946 Fax. 466-3053
Phone No. 40&2400
E -Mail: TLSEACOASTAIR@AOL.COM
State or County License: CAC01644U
if value of construction is $2500 or more, a RECORDED Notice at
requirea.
IJ=i j1ven/eryuIrveeM _ riot Hppucame I MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address
City: Stater City: State:
Zip: Phone: Zip: — Phone:
FEE SIMPLE TITLEHOLDER., _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _NotAppilcable
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counttyv mak eess no re reesgenntation that is grant ns a permlt will out orize the ermit holde to build the sub ect structure
which is In onfliet wK anyy ppllcabla Home Owfiers �9 ocladon rules, by aws or on9covenants t�iat may restrict �r pr Mbit such
structure. Paas®consult w7t your Home owners Association and review your deed for any restrictions which may appy.
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 OWNV: Your failure to Record a Notice of Commencement may result in your paying twice for
improvemants to
r property. A Notice of Commencement must be recorde and posted on thejobsite
before the first in tion.
If yo Intend to obtain financing, consult with len or an attorney before
commencingw orrecordin our tice of Commencement.
V/Rz� A�
V s
—signature Owner/ Lessee/ ent Signature of Conty ctor/Ucense der
STATS FLORIDA STATE OF FLO/RIDA
COWS OFsr�uM COUNTY OFrrwo[e
The fo oing lnstrum�pt was acknowledge efore me
this dayot Play 20 by
Personally Known x k M Produced Identification
Type of Identification Produced
Commission No.
Revised µ p MY COMMIS ui0u t 3o, 2018
1 4n.. AI atiafRES Aug
The fo oing instrume t was acknowledge'dd before me
this - day of 0 20 � by
Personsir?*Zwn L__4 Off Produced Identification
Type of identification Pr d
Commission No. (Seal)
MY COMMISSION aFF148072
EXPIRES AGrnl9t 3n. oni c
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