HomeMy WebLinkAboutBuilding Permit Application Jun 2016 02:58p Louie's Air Conditioning
7724295267 P.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �}
Date: �� Permit Number: 1 " lD 0 �
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Building Permit Application JUN 2 1 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:{772}4621578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
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Address:
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Legal Description; ,5 ./_.&
Property Tax ID* 4,02-• c 2MV'0 (9 0 1 - Q 10--? Lot No.
Site Plan Name: Block No.
Project Name-
Setbacks Front Back: Right Side: Left Side:
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wo to e e orme un er t rs permit-c ec a app y:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
FlElectric.
CD Plumbing FISprinklers 0-Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 3o.00 Utilities:jSewer Septic Building Height:
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Name Name-
Address:gRQLO Company:
City State:Stater Address: a
Zip Code:a_499): Fax: City: �- _ State:
Phone No. _Y'4Z. �•a`��•►'�CSL t� Zip Code:2,-jam Fax: c�- ��•' 2
E-Mail: Phone N... �-"
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Jun 2016 02:58p Louie's Air Conditioning 7724295267 p,2
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DESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicalaie
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE BOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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.p9rmit will authotize.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 pians,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 twicefor
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
,7- tee_
ature of owner/Agent/Lessee Sirnature of Contractor/License Halder '
STATE OF FLORID i " ' 'STATE'OF'FLO A
COUNTY OF �S . 1„7 A.�`,.t.Q, ;COUNTYOF a:
The rgoing instr ent was acknowled ed before me The forgoing instrument was acknowledged before me
this day of 20by this day of�, 20EMby
(Name of person acknowledging ,,...' `" " e of person acknowle '•, AMY K.PEARSON
,v:rte AMY K F'EARSON :�= Co=Ission##FF 235217
r_ COMMISS100FIF235217 !Expires Play 27,2019
ExpirmMay 27,20f9 ..H By+dedTMu7nYFdnfn+iratnlOD76SiU19
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{Signat re o otary Public-State 6f_FTD_r"Rc1-a7 to of Notary Public-State of Florida)
Personally Known OR Produced Identification Personal!• Known�4 OR Producers identification
Typeof Identification Prqduced Type of Identifica ouced
Commission-No. ; ; (Seal) • _ ` Commission No. (Seal)
Revised 07/15/2014. ,
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW 'REVIEW REVIEW REVIEW REVIEW REVIEW
DATE `
RECEIVED
DATE
COMPLETED