HomeMy WebLinkAboutBuilding permit 77287101863 p'2
Miranda Plumbing&AC
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ALL APPLICABLE I FO MUST BE CCIMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 i� ,/p
Permi4 Number: 0Y 7
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Building Permit Application
Ptonning and Development Services
Buddin;C and Code Regulation Dlvislon
2300 Virginia Avenue,Fort Pierce Ft 3#982
Phone: (772)462-1563 Fax: (772)162.1578 Commercial Re�`idential
PERMIT APPLICATION FOR: To Select from dropbox., click here'
PROPOSED INPROVENIENT OCATIO�Nc I I.
Address:
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Legal Description: h• 0 'i
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Property Tax ID#: -' CI >� tot No.
Site Plan fume; I slack No.
Project Name:
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Setbacks Front Back: _ Right-Side: Left Side;
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DETAILED'DESCR-IPTION OFWORK: I ,
CONSTRUCTICIN INFaRMATiON:
stional work to be ne-Frormea unclert s permit—check all appy: l
C Gas Tank ❑Gas Piping _Shutters II Windowsfaoors
Electric 0 Plumbing Sprinklers Generator ' `'� Roof
Total Sq.Ft of Construction: Scl.Ft. of First Floor:
Cost of Construction:$ 95-1 60 Utilities:FISewer I:j Septic Building Height:
OWNEk/ LESSEE: CONTRACTOR:
Name I Nacre e 7l ,M.
Addy s: Company:
City. State: Addr s:
u
Zip Code i ' "
Far City: ,��I State:
Phone No ' Zip Cade:qq I Fax:'� �N
E-Mail: i 1 Phone No.
Fill in fee simple Title Holder on neat ��Meren E-Mali: CO, �!f�.i l'L'2
from the Owner listed above) I State or County License: &5MLO
if value of construction Is$2500 ar more,a kEERDED Notice of Commencement is required.
Miranda Plumbing&AC 7728710 863 p.3
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DESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY.,'11:11 Not Applicable
Name: Name:
Address: I Address:
City: I State: City:
I —State:
Zip., Phone: I Zip: Phone:,:1
FEE SIMPLE TITLE HOLDER: blot Applicable BONDING COMPANY: I —Not Applicable
Name: I Name:
Address: I Address:
City: I City:
Zip: Phone: I 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 the Permit holdeptc,build the subject structure
which is In Conflict with any applicable Horne 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,th6 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'i'h your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
first.
before e firscinsper-tion. If you intend to obtain financing,consuLt�Hendef-o;�I! n attorney,before
11
Z=nd!l=r V®rcrec�oriyo=r Notice of CommencemepfF::"�
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Signature of Owner/Lessee/Agent on Licensd Holder
STATE OF FLORIDA STATE OF FLORID
1�e - C= a
COUNTY CI ix k COUNTY'OF
Th fc, ing;Inst we It 3ck owl edge before nff The f
p, ing Instpmprit was 84nowledged before rin
The
wa
th ay Of 20 gy g7e thixayof 20 '.0 by
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(Name of person acknowled Ing f- {Name of rs n acknowledging,}
{Signature of Notary P-ublic-State of Florida (!f1gri-ature of Ntid'y Public-State of Florida)
Personally Known OR Produced Identification' Personally Known L__ OR P'r'oduced Identification
Type of Identification Produced f Type of Identification Produced
Commission ND.f---t—H (Sl al) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONTZONING l SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE . I
COMPLETE
INITIALS
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