HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7728710863 p:2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date:,23A Ls' Permit Number: 1 Com 00 8-S
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
F.RQP'QSCE�D :MPROVEMENT LOC T1.ON:;= .. .. .:.... ....:.:: ...
Address: �3 EG'(1- ci I i f1' PC3L_ 06N.;
Legal Descriptio nk G' j`� 3 i (`t- `J C,-N10c)11ntS`�l'�
Property Tax ID 1�' — t "'1 L.� ' Lot No. � l
Site Plan Name: ° Block N
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILE_D•:DE5CRl.QTIO:NO `1NORK' ,.-': :_ '
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STftUCTl.O-IV�aN�FORl1%IATIOTt:~.�:.' -
Additional work;to bL
e Orme under tispermit—c ec a appy:
IHV Gas Yank E]GasPiping _Shutters Q Windows/Doors
Electric M Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq.Ft. of First Floor:
Cost of Construction:$ iii'�1�ni�C.` Utilities:05ewer ELeptic Building Height:
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Name a 'i t .F ,}. Name. :L
Addrpss: LIf✓lr.l.��'.�lgjf jCV- 110Ws2. Company:
City: r;C47� Stater Addr s:
Zip Cade��� Fax: City: c Stater
Phone No.� �_G' }✓ Zip Code.,-5L Fax:4 L- [ci 3
E Mail; -)'Q`1C'111<';�i1L;Y� Cdr it l i tf >1'+£Jc°� Phone No. ` (�
Fill in eee s`Wnple�A-e�io iteer�on next page (if different E-Mail 2"�';C:i✓f�,^{� ' .%N� i �t&i7a ltg
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from the Owner listed above) State or County License: G
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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Miranda Plumbing&AC 7728710863 p.3
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D SIGNERjENGINEER: Not Applicable MORTGAGE COMPANY: Not Asap icable
Name: Name:
Address: Address; 1
City: State: City: Sta e'
Zip: phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: „_,Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address' Address: '� 1
City: city: i
Zip: Phone: Zip: Phone:
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I certify that no work or installation has commenced prior to th a issuance of a permit.
St.Lucie County makes no representation that is granting a permitwill aut orize the permit holder to build the subject s ructure
which is in conflict with any applicable Home Owners Association rules,byPa or as�d covenants that may restrict or pro [bit such
structure.Please consult with your Horne Owners Association and review your deed forany restrictions which may appl
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 e
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twi for
improvements to your property.A Notice of Commencement must be recorded and posted on the j bsite
before the first inspection. if you intend to obtain financing,consult with lender or an attorney befor
commencing work or recording our Notice of Commencement.
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_ ignature of Owner/lessee/Agent ortractor/License Holder
STATE OF FLORIDA STATE OF FLORIgA
COUNTY OF �—,-F _'+l ,�' COUNTY OFi
The f rgc'ng Instrixment was a knowledged before me The forfoing instrument was acknowledged before m�
this 'day of -t J(A L 20 LL2-by thisi�L day ofQb'� of 20 L�by
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(game of per cknowl gin %-.1 � (Name of pe n acknowled f
'-•��ftr' � rft � �� �t3 '�` �'r`�� Oi
ignature of Notary Public-State of Florida a CF=
o ig ature of Notiic-State of Florida) c14�$
�Sunwry,r
Personally Known 5 f:�1'6R Produced Identificati ••u�t r"pry. Personally Known
OR Produced Identification
Type of Identification Produced r Type of Identification Produced
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I �1 a-J r^— k Seal
Commission No. (Seal} ,��;,,�,, ;: Commission No.r, ��'��1��� (Seal) s' m,'�°'�
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE M/ NGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS