HomeMy WebLinkAboutBuilding Permit Application Jan 1916 02:30p First Choice Plumbing 7728797860 p.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: d 6 Permit Number:
RECEI'."7D JAN 19'2016
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 1 �'
PROPOSED IMPROVEMENT LOCATION:
Add ress2c5 111
Legal Description: ' LCA
Property Tax 10#: N0t'E%o- Z Lot No. _
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
U tk
CONSTRUCTION INFORMATION:
Ackdktionai work to flasTank
Orme un er t is permit—c ec a appy:HVAC ❑Gas Piping 1:1CGenerator
Shutters Windows/Doors
Electric Plumbing Sprinklers Roof
Total Sq.Ft of Construction: Sq.Ft.
.of First Floor:
Cost of Construction:$ 1 0 0 • 0 C) Utilities:11 Sewer USeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Nam Name. 3 sic
Address Compa %-V%,AA
City: ! State:_FL Address:
Zip Code Fax: -- {r City:y9t Stater
Phone No.��S (D Zip Code Fax:—n-.)' 01 +—t';IX
E-Mail: Phone No.—T1
Fill in fee simple Title Holder on next page(if different E-Mail 1 1 g(A
from the Owner listed above) State or County License.
it value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 4
7
Jan 1916 02:30p First Choice Plumbing 7728797860 p.2
SUPPLEMENTAL CONSTRUCTION LIED LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: T 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:
1 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,l do hereby agree that 1 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 ay result in your paying twice for
improvements to your property.A Notice of Commencement mu Corded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consul ith len a an attorney before
commencWk work or re=ding your Notice of Comment_Azna____ /�\� - nt.
S
Sigliature of Owner/L see Age t WnUare of Contractor/Lice Bolder
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STA E OF FLORIDA '� �,�ccc TY OFFLORIDATEE OF �'j 61CO NIA
OF !
�Tt
for oing instrument was acknowledged before me The for o!instrument was acknowledged before me
is oAay of. 20 l by this J day of /f)L/flf-'-z20 f�by
(Name of person acknowledging) (Name of person acknowledging)
(Signature ofotary P btic-State of Florida) (Signature of No ry Public-State of Flori a)
Personally Known OR Produced Identification Personally Known JC. OR Produced Identification
Type of Identification Produced Type of Identification Produced
Co Commission No.
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