HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; 'aI a v5 Permit Number: d y
RECE1'."^D DEC 02 2015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2800 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
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Address: 3870 N A1A 506
Legal Description:
Property Tax ID#: 1423-805-0028-000-5 Lot No,
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:, Right Side: Left Side:
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I—ti ona wor R to b e 0 erfoftmed under this permit—check a app y:
HVAC Cas Tank ❑Gas Piping _ Shutters Windows/Doors
11 Electric 1:1Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: S. , Ft.of First Floor: _
Cost of Construction:$ 4665.00 Utilities:ll Sewer Septic wilding Height:
i111 4,1411
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NameALAN ZINGAE Name: JOHN V LANGEL
:
Address:3870 N Al LOB Company: SEACOAST AIC
City: FORT PIERCI= State:FL Address: 2601 INDUSTRIAL AVE 3
Zip Code: 34949 Fax: City: FORT PIERCE State:FL
Phone No. Zip Code: 34946 Fax: 772466-3053
E-mail: _ Phone No, 7724662400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSF-ACOASTAIR@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.
wh ch i�n conrlicmt With any applicabfelHome owns sAssoc ation rules,bylaws or andpcovenants thap build
oleproll bit Such
structure.please consult with your Home Owners Association and review your deed for any restrictions which may apply,
1n consideration of the granting of this requested permit, I do hereby agree that I will,in aft 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 T9 OWNER:Your ilure to Record a Notice of Commencement
improveme s to your pro rty,A Notice of Commencement must be r orded anresult ld poste paying
twice for
he jobsite
before the r t inspection fou 1 nd to obtain financing,consult w' lender or at
commen ork or rec di y before
Notice of Commencement.
Sig re o wner/Less /Agent
Signature
S OF F1 ORI ontractor Licen Holder s
NTY OF STLIICIE STAT FLORIDA '
// COU OF STLucl�
The fo Ing instr a4n wled
this y of g e'fore me The oing Instr nt was aeknowled
20 y this e me
day of �J 20� by
V LANGCL-i
a e of p on ac owledging) sort N13EL
a e o person acknowl d ' g)
atur p
Perso Known x e N rY ublic- f Florida)
Y R Produced Identification
Tvp f entificatton Produced Personall nown x -
type of entlfication produced Produced Identification
Commission N ,z1,.�r�'^*.� GYK,WJ#ANG1`L
MY COMMISSION 05148072 o GEL (Seal)
r" 90.201 t3 i'j MY COMMISSION*FF148072
Recused 07/ Jq153 Fiorloallotaryservice,oam •�� fwn
4.071398-0153 F1orlriallotaryservice.com
REVIEWS FRONT ZONING SUPERVISOR PLANS
COUNTER REVIEW REVIEW . VEGETATION SEA TURTLE MANGROVE
DATE . REVIEW REVIEW
COMPLETE REVIEW REVIEW
INITIALS
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