HomeMy WebLinkAboutBuilding Permit Application Jul 13 16 08: 35a Treasure Coast A/C 7723359121 '. p. 2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE,ACCEPTED `�
Date: Permit dumber: Ito 0 ( • CAP
� ` ="` ..• 5� Building Permit Applicatl'®In
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 - t Residential
i
PERMIT APPLICATION FOR: To Select from dropbox, click arrow,6t the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: i t� .a� �C Lil 'i
Legal Description: jc �^{1� L rC^� j c�C ✓ t ` L v
a
i
Properly Tax ID#• Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side.
i
DETAILED DESCRIPTION OF WORK:
r�Ii'. �'1 �C Ui« Ci�J- jc "mss: ? �•, j't::cid ���`-Cr 1 �. GLbkr-r �.o-rlLpLc-bzf—
CONSTRUCTION INFORMATION:
AddI
itiona wor to a orme under this permit-check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters ; Q Windows/Doors
Electric Plumbing ❑Sprinklers E Generator' Roof
I ,
Total Sq.Ft of Construction: So.Ft.of First Floor:
Cost of Construction:$ ��� • Utilitiestj Sewer 0 Septic � Building Height:
OWNERAESSEE: CONTRACTOR:
_ ✓��/Name Name:
Address: ;,5-'] ✓ - �C��(�c J� Company: >� ; C�{r'it�t
City: a 3,i�:.t'%� State:%- Address: P-1-1 1�3:,A
I �r
Zip Code: �t t�i�i� Fax: City: c i�zrJ �c=tl State: &L
Phone No. /?',2- .3q3i1: Zip Code: `1- Fax: '7i'Z-35
`>r(l-24
E-Mail: Phone No. -'a'
Fill in feesimple 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.
I
Jul 13 16 08: 35a Treasure Coast A/C 77133359121 P. 3
I
I
SUPPLEMENTAL CONSTRUCTION LIEN LAV'INFORMATION-.
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: Riot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
•
1 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�rermit 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.
Inconsideration 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 Commencemarat-nay result in your paying twice for
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 ilender or an attomey before
commencing work or recording our Notice of Commencement.
i
Signttvre of Owner/Lessee/Agent Signature-of Contrad,or/License Holder
STATE OF FLORIDA STATE OF FLORIDA � w
COUNTY OF .�-fir-r;I:�1 COUNTY OF
I
The forgoing instrument was acknowled edefore me The forgoing instrument was acknowled ed before me
this day of_ ter•!cam- 20 %(-by this �,'�day of JY It 20 c L by
i
(Name of person acknowledging) (Name of person acknowledging)
I
(Signature�Notary Public-State of Florida) (Signature df tary Public-State of Florida)
Personally Known V� OR Produced Identification Personally Known '/I-OR Produced Identification
Type of Identification Produced Type of identifications Produced
• JOj ADAMS
Commission No. "'••:;% I Commission No. .JO DAMS
Nw-Comms Sion 4 FF 907740 ,��
My Commission Expires Commission 4 FF 907740
=� '= M'y Commission Expires
n,n.a•
w January 14, 2017
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
I