HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ff
Date: 9/1/2016 Permit Number:
E C EV O
Building Permit Application SEP 0 10�
Planning and Development Services
Building and Code Regulation Division PEP,P4ITTING
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical 1 C F
M-1
PROPOSED]MPROVEMENT LOCATION..,
Address: 6007 Raintree Trail Fort Pierce
Legal Description: INDINA RIVER ESTATES-UNIT 09-BLK 71 LOT(MAP 34/11S)(OR 857-2926: 942-2120:
1427-982: 3357-1791)
Property Tax ID#: 3402-610-0049-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Murphy
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION ,OF WORK.
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Or) an Shy)-e ✓m�.
CONSTRUCTION,-INNFORMATION -
Additional work toe e orme under this permit—check a that appy:
HVAC 11 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers F]Generator Roof Roof pitch
Total Sq. Ft of Construction: : S . Ft.of First Floor:
o
Cost of Construction:$ o Utilities:CnSewer Septic Building Height:
,OWNER/LESSEE `CONTRACTOR.
NameJudith Murphy Name: James Ogle
Address:*6007.Raintree Trail Company: Simply Solar Services
City: Fort Pierce State:FL Address: 866 Duncan Ave
Zip Code: 34982 Fax: City: Kissimmee State:FL
Phone No. Zip Code: 34744 Fax: 4078475013
E-Mail: Phone No. 4078467830
Fill in fee simple Title Holder on next page(if different E-Mail: Info@simplysolarservices.com
from the Owner listed above) State or County License: CWC035772a
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
<S 169 ,00
SUPPLEMENTAL CONSTRUCTION LIEN. LAW 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: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: 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 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 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 Commencement may 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 lender or an attorney before
commerWing work or recording our Notice of Commencement.
s
Signat of Owner/Lessee ont ctor Agent for Owner Signature of ntractor -cense der
STATE OF FLORIDA. STATE OF FLORIDA
COUNTY OF _ COUNTY OF 97,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this J day of Ci 20 I Eby this day of ;�� ,20 t_1p by
(Name of person acknowledging) J (Name of person acknowledging) �^
a
c
(Signature of Notary Public-State of FI a) (Signature of/Notary Public-State of Flo ' )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced n, ) , Type of Identification Produced
Commission No. pp �( p� /+ {/� Commission No. °" P�`•;, MAX� I6OSIANZO
•.•�ppY P°g'• ItlYA/�IIV E COS 0 ANZO
MY COMMISSION#FF1 75797
MMISSION #FF175797 'a s'' oQ
Nj: :OPS •�� ES ,
. 20 18
-yrF----o�; EXPIRES December 5,2018 °'M1°'
Revised 07/15/201 (407)398-0153 FlorldallotaryService.com
407)399-0153 MoridallotaryService.com
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