HomeMy WebLinkAboutBuilding Permit Application 02/15/16 08:03AM Adam's Air Conclitio mi q, Ir 772-878-3951
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:(-�2 )e_ Permit Number: _
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 V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
R `o �MROVET IpCATIOIV '•.i' , m,t
Address: `� '��3 I SS'��' � IncK--) ..
� !^
Legal Description: 7� Y�x``'�'✓' 1.1 CL1,�L F'112 1)l�f _<
Property Tax ID#: �f�?.5 1�W ' U U �� Lot No.�
Site Plan Name: // Block No.
Project Name: !�,ils'o
Setbacks Front Back: Right Side: Left Side:
DETAILED'DESCRIPT16ft WORK:
CONSTRUCTION INFORMATION:
Adclitignal worK toe Performed un er t is permit—check a appy:
HVAC E.Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric II Plumbing Sprinklers 11 Generator � Roof
Total Sq. Ft of Construction: 1 X' - Sq. Ft.of First Floor:
Cost of Construction:$ ` IC/J4•t1U Utilities:0 Sewer Septic Building Height:
OWNEROC SEE: CONTRACTOR:
Name Name:
Address: 7" °�' Company:
City: {� State: '_ Address:
Zip Code: �� � Fax: City: State:
Phone N477-20 cll``�cJ�'� Zip Code: Fax:
E-Mail: Phone Nc� ��t L :f LIZ-
Fill in fee simple Title Holder on next page(if different E-Mali:
from the Owner listed above) State or County License:
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
02/15/16 08:03AM Au's Aiz Concli ti.i r�ninySnc 772-878-3951
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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: 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.
St. Lucie County makes no representation that is granting a permit will authorize thepermit 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 failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. ANotice of Commencement must be recorded and posted on the jobsite
before the first inspection. If • tend to obtain financing,consult with lender or an attorney before
commencing work Qt-r ing yourNoti �f Commencement.
gnyre of• net/Ag /L e Sippatur of Con tactor/Lic se H r
STATE OF FLORIDA: STATE OF FLORIDA
COUNTY OF ,'l 1 COUNTY OF_'S-1 t _,(_7L !L_:,1
The f r Qing instrI ment was acknowledged before me The t rgo ing instrument was acknowledged before me
this ay of t j]�y�' ri. 20?by this bay of 20 by
fit,; 6;J -
(Name of person acknowledging) (Name of person acknowledging)
Si nature of Notary Public State o�
( 'g y f Florida) (Signat re of Notary Public-State of Florida)
s
Personally Known V"'
OR Produced Identification Personally Known `' OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No.
LYNNETTE HAMILTON LYNNETTE HAMILTON
MY COMMISSION#FF948668 MY COMMISSION#FF94M68
JanuaryFEXP EXP
aw
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS