HomeMy WebLinkAboutBuilding Permit Application Sep 16 2016 05:11PM HP Fax page 1
ALLAPPL BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Permit Number:
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Building Permit Application SEP 16 2016
Planning and Development Services PERi.'AITTING
Building and Code Regulation Division S ie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)452-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Plumbing
Address: ��
Property Tax ID#: 2�5 ~ "` V?. C1 V Lot No.
Site Plan Name: n
Block No. '-/— .
Project Name.
Setbacks Front Back: Right Side: Left Side:
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MW
_113 110MIN
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1; �:'510 , I
mons wo o e e arm un er s perms —
HVAC P G ank ❑Gas Pipi _ hutters F Windows/Doors
Electric Plumbing Sprinklers Generator [.41 Roof Roof pitch
Total Sq.Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 14-)-1<
l � Utilities: Sewer LJ Septic Building Height:
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Name Nam
Ad $: Company:
Ci State: Add JLA
Zip Code: Fax: City: State:
Rhone No. lJ Zip Code: Fa 6
E-Mail: PhoneNo. [:
Fill in fee simple Title Holder on next page(if different E-Mail:
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from the Owner listed above) State or County License:ie� 1
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Sep 19 2016 01:47PM HP Fax page 3
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
e Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Nat Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City
Zip: Phone: ZIP: Phone:
I certify that no work or installation has commenced priorto 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,
accessary structures,swimming pools,fences,wails,signs,screen room and accessory uses to another non-residential use
ai!U RNING TO OWNER:Your failure to Record a Notice of Co rnencement may result in your paying twice for
!FoWcing
your property. A Notice of Commence t must be recorded and posted on the jobsite
t i spectian.if you intend to obtain financ' ;consult wit der or an attorney before
r ordin our Notice of Comrnen ent.
r to f Owner/Lessee/Contractor as Agent for Owner g atu a ntractor/ is se Holder
JTA E'OF FLORIDA T TE F FLORIDA
O NTY OF O N OF `
Th ' oin lin r s a I d etillb ore me The f oing inst was knowledged before me
day, f 4 ' y this day of 20 1 _a by
( ame of persAacw1ker%),,.ac { Mme of person ac o i ng)
NSAr
Mhkure of N to Pub c-State of Florida) ig ature of No a ub State of Florida)
er onall Kno n OR Prod ation Personally Know OR Produced Identification
of entifi IWIMe t0tr Type of Identification
a==id q=V4 s3ilidX3 SH"108 AN
Commis Abid#NoJSSIWK00 AW i.;( I Commission No. My coM )V 0 FF972PS
KiWdlI�VB iiit riilfN>; ' y 221
EXPIRES March 17,2020
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Revised 07115/2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
=INITIALS