HomeMy WebLinkAboutBuilding Permit Application FROM :DNS Services FAX NO. :7723446402 Jun. 16 2016 2:51PM P1/3
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO 88 ACCEEFrrED
Date: Permit Number
Building Permit Application
Planning and DevelopmeneServkeS
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierre FC 34982
Phone:(772)462-1553 Fax:(772).462-1578 Commercial Residential
PE RMITAPPLICATION FOR: McOanical .
Address: PW-
61
Legal Description: J Q
Property Tax ID##:•0lee,!—b I D4- 400 -'Z _ Lot No._-.
Site Plan Name:.. Block No.
Project Name.•
Setbacks Front Back: Right Side: Left Side:
- !.Y iii,• :Y.
.:.` 1 i
ACCItiOnal vror orm un raspertn - e a app Y::
HVAC ��--••��Gas Tank 11Cas Piping Shutters ❑Win
xlaws/Doors
Electric L_1 Plumbing []Sprinklers Generator Roof
Total Sq.Ft of Construction: 16-1 -1 S .Ft.of First Floor:
Cost of Construction,$ •D� Utilities"nSewerSeptic Buil'dingHe!&:
RACT
Name Name: DOUGLAS PENCE
Address:�a,.1Qh;+ie f�i{"' Company: ABSOLUTELY COOL AIR CONDITIONING
GRy: t"nrairn State:FL Address: 2311 NE 15TH COURT
Zip Code: I 1:2a-7 Fax,• City: JENSEN BEACH State-FL
Phone No - CO Zip Code: 34957 Fax;
E-Mail: -�--�^� Phone No. 772-475-4641
Fill In fee simple Tide Holder on next page(if different E-Mail: absolutelycoaleir@gmail.ocm
from the Owner 11sttsd above) State or County Uoense: CAC1815702
1f value of Ooralruction is$2=1 of more,a RECORDED Notice of Commencement is required. -
i
FROM :DNS Services FAX NO. :7723446402 Jun. 16 2016 2:52PM P2/3
DESGNER/ENrjWffA: Not Applicatbile MORTGAGgCoMpAW.
0 Not Applicable
Name: Name:
Address: MORTGAGEE
T. Cit..
City: State: City: -State.
Zip: Phone Zip: PRO—rie:
FEE SIMPLE TITLE HOLDER. Not Applicable BONDING COMPANY: .,._,Not Applicable
Name: Name:
Address: Address:
City:
Zip: Phone: Zip, Phone.
OWNER/CONTRACTOR AFFiOVIT.Appliattwishereby made toobtain*permit to do the work and Installation as indicated.
I certify that no work at Installation has commenced prior to the issuance of Permit
r
4.Lucie Coun makes w representation that is granting a Fermit Will authorize the permit holder to build the subject structure
11%r
I lica at
Which Is In cc withaWpi bit Home owners Asjoc ation-tul",bylaws or and cbVenantsthat-may Testrictor prohlbu-Ach
structure.Please consult your Home Owners Association and review your dead for any restrictions vAkh may app
In consideration of the gmnft 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.Lucia County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review;room additions,
accessory SITuCtUMS,SWIMMIAg Pools,fOnCO%wells,SISM,ween MOM find accessory Uses to all*ther non-residential use
WARNING TO OWNER,Your tallum to Pjacord a Notice of Commencement tray
result wft trite for
improvements to your pr Notice of Commencement must be recorded d po d on the jobsite
before the first your
n.Ify intend toobtainfinanCeling,cconnsu h tend r or an mey before
SW
ctxn
J"W
intend t ricin atill
"Ll
h o"'I a
m wo 'w
x ecordl your Notice Commencement
nature
re ne,Agan"L.. nature
". of
ature wnerl Agent/Lassue na reof ntra&*r/Licvr&-liotder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF— 1515+- COUNTY OF--- , .Lzw;e-
The f. ft Instrument was admo led before roe The forWris instrument was acknowleclad before me
a--- by thIS4408ayof afjAig- '20agby
V
Dc-uaLas
(Name of pksbn acknowledging) (Name of pe rwA acknowledging)
(signature of Notary Publk,State of Florida) (Signature of Notary Public- teal'torida)
Personally Known-,�OR Produqed.loejt(ficaticn Personally Knows. OR PrOdUmd Identification
Type of I entificatlo.. A� A Do of Identification Produced
DEBORAH RUSSELL
'k mission No. H
colvimlssion No. 01 Florl S
NOt2tWfic-State ol Florida Notary"bit,.State of
..'my comm.Expires Nov 30,2018 0 It 2018
--imy Comm.Expiras Nov 30.2018
CdtnmF- n#FF 179630
Boadd through Nall0nat Notary-Assnr ssio
Reviseal)7115/ Bonded through National Notary Assn,
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