HomeMy WebLinkAboutBuilding Permit Application 12/21/2015 14:52 7724662417 SEACOAST SHEET METAL PAGE 02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TOM ACCEPTED 2 b
Date: 12-21-2015 Permit Number:
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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 x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address; 3100 N A1A PH D3
Legal Description:
Property Tax ID#: 1425-6060061-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Mona wor o e e Orme un ert Is permit—cheG a appy:
7 HVAC Gas Tank ❑Gas Piping _Shutters 11 Windows/Doors
11 Electric ❑Plumbing ❑Sprinklers Generator Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 5216• Utilities:n Sewer Septic Building Height:
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Name KATHLEEN McBee Name: JOHN V LANGEL
Address:3467 EDINBURGH RD Company: $EA COAST
City, GREEN 6AYState:WI Address: 2601 INDUSTRIAL AVE 3
Zip Code: 54311Fax:_ ____.._ City_ F9 PIERCE State:FL
Phone No,727-271-2713 Zip Code: 34946 Fax: 466-3053
E-Mail: Phone No. 466-2400
Fill in fee simple Title Halder on next page (if different F-Mail: TLANGEL a@SEACOASTAIR a@AOL.COM
from the Owner listed above) State or County License: CAGO16446
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
12/21/2015 14:52 7724662417 SEACOAST SHEET METAL PAGE 03
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DESIGNER ENGINEIER: _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 is noconfiicmakes
w th any representation that As ocipermit rules,bylaws or the permit
that may esti restrict or pro 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 failure to Record a Notice of Commencement may result in your paying twice for
improvements your proper y.Aa of Commencement must be recorded and posted on the jobsite
before the firs nspection. IfoT7tXdtto obtain financing,consult with lender r an attoeor r cor n otice of Commencement.
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_5ignatdr f Owner/Lesse gent Signature of Contra rJl icense ql r
STATE FLORIDA STATE OF FL CDA
COU OF sTLUc{E COUNTY OF srwClE
Thefo {ng instrume t s acknowledged le me The forgoing instrument was acknowied re me
ti7' day of _ _ 20/[� this �� t1
day of ECEMEERj
�y
Na on acknowied i {Nam p rson gi g j
D `
r
(Sign re of P !silt,-S a "d a ' (Signa ure t` .P a 5t of Florida
Personally Know x oR raLd a tiflcation Pers Kno n -c R Pro ed Identification
Type of identification Produce '—` '" o Type of ident!I I& u ed
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Commission No. ) Commission N o us (Seal)
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Revised 07/15/2014 � m � � 3 � 5 �
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REVIEWS FRONT SUPERVISOR PLANS V SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW
REVIEW REVIEW
DATE
COMPLETE
INITIALS