HomeMy WebLinkAboutBuilding Permit Application Dec 1015 02:26p First Choice Plumbing 7728797860 p.1
ALL APPLICABLE INFq MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: `i C
Building Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-M3 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine
PROPOSED IMPROVEMENT LOCATION: .
Address:M ti,� Q_jamanc>` Ruc—, nS A. !�:& `ys �e_ \^ ' 343L S` I
Legal Description: !� \ca_r
Property Tax ID#:3!A - $3D-0aLoq-Ooa-LQ Lot No.Site Plan Name: Block No..4�
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
itona wor to e e Orme under this permit-c ec a appy:
0HVACE]GasTank El-as Piping Shutters aWindows/Doors
t
Electric U Plumbing Sprinklers M Generator Roof
Total Sq.Ft of Construction: S .Ft.of First Floor_
Cost of Construction:$ (��.0� Utilities. Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name e5 Name: \c Lr, u Cl
Address: % c s'} Company: e l
City j� State:EP, Address: n an e a EW
Zip Code:J(Q?aS Fax: City,-98A 9c LM State:_U_
Phone No. Zip Code:bA9$A Fax.-179 g7Q-lgla�
E-Mail: Phone No. -
Fill in fee simple Title Holder on next page(if different
from the Owner listed above) State or County License: 1
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Dec 1015 02:27p First Choice Plumbing 7728797860 p.2
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: NotAppilcable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip:_P hone:
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 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 OWNER:Your Miture 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
befoXrthe first inspection.If you intend to obtain financing, lender an attorney before
co in work or recording your Notice of Commence ent.
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Sig ature of Citer!Age�)Lessee S' ' u e of Contractor cense Holder
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(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida
Personally Known V ORProd tion Personally Known OR Produced Identification
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Type of Identification Produced
- ratification cation Produced
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