HomeMy WebLinkAboutBuilding Permit Application 03/18/2016 07:11' 7724612036 STEVE SMITH AC PAGE 02/03
ALL APPLICABLE!PFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEEP 4 V1W
Permit Number_
Building
Building Permit Applicatibn
Planning and Development Services
Building and Code Regulation Division
2.300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Res!entiBl
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of litre
NEW
AZ
Address.
Legal Description: .A;zrC,Xeor,-r
Property Tax I D.#-. Lot No.
Site Plan Name: Block No.
Project Name,
setbacks Front_ Back:_Right Side: Left Side,' :
i 3111i
g
MINE=! I
ZX
gAddlitEffionalWwotoWe-De ormed under-thispermit—che a apply,
L
P5erml,1c ec a appy: Windows/Doom
WHVAC Gas Tank EIGas Piping utters 0
Electric* Q Plumbing OSprinklers; Elr, Roof Generato El
Total Sq,Ft of Construction.Z� sq.Ft.of First Floor;
feV
Cost of Construction:$ utilities:0 Sewer5eptic I Buildihl�g Height;
kv on=
Name
Name- 8teve Smith Name
Address: Company: Steve,,5mithA#Co2L*ning
CJW. 5 atv
8001 Eden Rd
City eI
Statet Address:..
:1
Zip Code: Fax: City..Foft Pierce State..
Phone'No. Zip Co.de: 34951 772 461-2036
—
Phone No. 772 401-1425,
:1
FIII In fee simple Title Holder on next page if different E-Mail: stevesmtfiaC@aolCom
from the Owner listed above) State or County License: CAC1810454120071
J
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.',
03/18/2016 07:11 7724612036 STEVE SMITH AC 1I PAGE 03/03
NE
DESiCNERIENGINEER: Not Applicable MORTGAGE COIVIPANY'I; Not Applicable
Name: Name:
lAddress: Address; i.
City: State: _ City: !! J, state:
Zip: Phone. Zip: Phone:I
FEE SAMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: ' Not Applicable
Name: Name:
Address: Address: I.
City: City:
Zip: Phone: Zip: 'Phone:
i;
I certify that no work or installation has commenced.prior to the issuance of a permit.
St.Lucie Count 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 cjovenants 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,pe'rf'orm 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 accessoryi uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement M`ay resylt in your payft twice for
improvements to your property.A Notice of Commencement,roust be recorded Wand posted on the jobsite
before the first inspection.If you intend to obtain financing,consult with,lender-br an attorney before
commencing rk or repoTding your Notice of Commencement.
i
s
Signature of caner/Lessee/Agent Signature of Co tractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The fo oirig Instrument was acknowledged before me The forgoing instrument wasp a cknowledged before me
this T day of 7Vn( 20 J�by this day of �;Pfl� --=20 by
(Name of person acknowledging) (Name of person acknowledging)
I�
(Signature
" Notary Public-of —mac State of Florida)—� ' (Signature of Notary' Public-State of Florida
f
Personally Known ,OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of identification Produced
Commission No.R-21(103 -
fission No. jl Seal
'a I R1 Moon
STATE OF FL I NOTARY PusuC
STATE OF FLORIDA
Revised 07/15/2414 EWm&jjr J Cam*FM12CO 51117/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION , SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW ', . REVIEW REVIEW
DATE
COMPLETE
INITIALS
I�
i� I'