HomeMy WebLinkAboutBuilding Permit Application 12/08/2015 11:58 5615863739 ECM PAGE 01
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' 1'S Permit Number''I 5�A-0 a
RECEIVED DEC 0 8 2015
S
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1SS3 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Plumbing - uJq�-� C �sLg4.P
PROPOSED IMPROVEMENT LOCATION:
Address `rt i a
Legal Description: &) W_e s ► lQ t
S��IOr�( /��J]�g� S
Property Tax ID#: 34 aLP - -90D - W!_JW- ODCO Lot No. 2,5
Site Plan Name: Block No.
Project Name:N :N �l
O l JI
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE HWH CHANGE OUT-40 3CO�QOS
CONSTRUCTION INFORMATION:
Adclitional woll,to Drrormed under tispermit-check'a appy:
�]GasTank
HVAC Gas Piping _Shutters Windows/Doors
Electric ❑Plumbing Sprinklers Generator El Roof
Total Sq.Ft of Construction; ... . S .Ft.of First Floor:
Cost of Construction:$ `io�T�J�.J -CO Utilities, Sewer Septic Building Height-
OWNER/LESSEE: TRACTOR:
Name'MC Name: ALAN LeFOY
Addre 5 Y company: EAST COAST MECHANICAL
City: State:F1— Address: 1500 N HIGH MOGE RD
Zip Code: Fax: City: BOYNTON BEACH State:FL
I I Zip Code: 33426 Fax: (561)493-2701
E-mail: Phone No. (561)686-3739 EXT 2020
Fill in fee simple Title Holder on next page(if different E-Mail: PERMITS C:.CMSF_RVICE,COM
from the Owner listed above) State or County License: CFC048260
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
12/08/2015 11:58 5615863739 ECM PAGE 02
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: r
DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address:_ Address:
City: State: City: Stater
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name;
Address: Address:
City: __._...__.. City: -
Zip: Phone: Zip: Phone:
1 certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Count 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 dnd review your deed for any restrictions which may apply.
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 applicationsr:,re 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/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE FLORIDA
COUNTY OF PALM BEACH COUNTY
OFFALIAHM N
The f going ins men was i nowledged before me The f going instrument was acknowledged efore me
this day of \ �, ZO'! by this day of ,20—D by
Al AN LaFOY ALAN LaFOY
(Name of person acknowledging) (Name of person acknowledging)
(SignatuNotary Public,State of Florida 1 (Signature of Notary Public5tate of Florida)
a.���7�1�'4 (COIL MBQUitB x OR Pr IdentifiC tion
Personally Known x C 'i ' I '+ 2ss56 Personally Known RtdtlIjiC0I2 !a r@
Type of Identification Produe�FJ '� 1 Type of Identification Produce '°��
iir
Commission No, f '��i,�+���`�~ (WedthrU Aaron Commission filo. s sbohs:October 19,2019
nf�,� �� Bonded thru Aaron Notary
Revised 07/15/2014
it
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS