HomeMy WebLinkAboutBuilding Permit Application 09/08/2016 07:36 7724612036 STEVE SMITH AC PAGE 02/03
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /6 Permit Number: ltd V L "o 105
ECEH11 VER D
Building Permit Application SEP 0 8 2096
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County,/FL
2300 Virginia Avenue,Fort Pierce Ft 34982 /
Phone:(772)462-1553 Fax:(772)462,157$ Commercial Residential ►/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of tine
Address:
Legal Description: (o�
Property Tax ID Lot No. 1�
Site Plan Name: Block No. �
Project Name:
Setbacks Front_ Back: :Right Side: Left side:
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�T., /�✓s��,� ��rarT ,oma �. �� .��(�/ �'� /.0 ��'��` •
ores o rme un er c ec a app.X-
HVAC Gas Tank : Gas Piping _Shutters Windows/Doors
C3Electric Plumbing ❑Sprinklers Generator ❑Roof
Total Sq.Ft of Construction: $0, Ft of First Floor:
Cost of Construction: utilitiesSewer OSeptic Building Height:
Name:-Steve Smith
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Address: Company:
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CityAddress: 8001 Eden Rd
Zip Code: ��r _ Fax City: Fort Pierce - _ State:FL
Phone No. 7�2--Wf- Zip Code: 34951 - - ----- Fax• 772 461-2036
E-Mail: Phone No. 772 461-1425
Fill in fee simple Title Halder on next page(if different E-Mail: stevesmthacCaol.com
from the Owner listed above) State or County License: CACIS13454120071
If vak,e of Construction is 0500 or more,a RECORDED?Notice of Conmencenwat is required.
09/08/20I6 07:36 7724612835 STEVE ' ITH AC PAGE 03/03
71-1 Com*FF231200
STATE OF FLORIDA
Revised 07/15/2014 E"a 50111fM9
MPANY:---'- Not Applicable
DESIGNER/F-NGINF-ER.- "No�AWpphcable7it GAGM�Cft
MO T
ddress: Ad
A a 7c I
City: State:, State:
Zip: Phone: Zip: Phone.,
FEE SIMPLE TITLE H LDER: —X 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,,Luc!e Coun, ermit will authori2e the permit holder to build the subject lucture
w chi �makes no representation that is granting 6
s in con ict with any applicable Home Owfiers;Association rules,bylaws or and covenants that may restrict o Sibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may a6ply.
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 Nil concurrency review';room additions,
accessory structures,swimming pools,fences,walls,sigbs,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
commencing work or repqFding your Notice ofCommencement.
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF. COUNTYOF
The f oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida (Signature of Notary Public-State of Florida
Personally Known OR Produced Identification' Personally Known A OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. NWDTMY Ission No. Won N11150 SK4114110ft
STATE(QWF NOTARY PUBLIC
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION 5EA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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