HomeMy WebLinkAboutPermit application ALL APPLICABLE INFO MUST KCOMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. 9-A -� Imo.. Permit Number: I U10- o3J a
Building Permit Application
Planning and:Development Services.
Building and Code Regulation:Division.,
2300 Virginia Avenue,Fort Pierce.Ft 34982
Phone:.(772)462-1553 Fax:(772)462-1578 COt711'YIe,rcia,l Residential
PERMIT APPLICATION FOR. Mechanical
PROPOSED INPROV,EMENT LOCATION '°
Address: �.Cdq '#
Legal Description::V.0r-VIc..7Q_ei CJr'C;;L-z -bgT -c C)t v
Property Tax ID#. CDQ-1— - L� -.11 Lot No.(B-. Ic)
Site.Plan Name:
Block No:
Project`Name: l.4,>G L-C-AA,
Setbacks Front Back: Right Side, LeftSide: .
DETAILED DESCRiPTfON Q1=VUC+RK ` ` "' _ 7 4`
t
CONSTRl1CTI0N IRMATION:
NFO
.:... . .
itiona _wor to: e e Orme :under this permit--c e-c. all=applyt,
RJHVAC. :Gas Tank Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total 5q.Ftof Construction: -"h. Sq. Ft.of First Floor:
Cost of Co.nstructio.n:.$ .�� lid Utilities: SewerL_jSeptic :Building Height:
OWNER/_LESSEE CONTRA' O
°t Ct'T R
Narrie eAcf, Namei DOUGLAS'PENCE
Address:'?o o iQ (ee fZ. Company: ABSOLUTELY COOL AIR CONDITIONING-
City:C Aark6+,66 State:M.V Address: 2311NE 15TH COURT
Zip Code. Fax: Ci JENSEN BEACH FL
k
_. _ City.. tate.
Phone No: r.�( Zip Code: 34957 Fax:
E-Mail: Phone No 772-4754641
Fill in fee simple-Title Holder on next page(if different E-Mail:absoiutelycoolair@gmaiLcom
from the OWner listed:above) State or County License: CAC1815702
If:value of constructional$2500 or more,a RECORDED:Notice of commencement Is required:
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DESIGNER/ENGINEER: Not Applicable Mt9R1'GAGE'CCIMPANY Not Applicable
Name: Name:
Address: Address:
City% State: . City: Stale.
Zip Phone: Zfp% .Phone:.
FEE SIMPLE TITLE HOLDERc Not Applicable Ra>Yia[NG COMPANY: _;.LNot,A pplfcabie
Kane•
Name:
Address: Address:
City' city:
Zip: Phone: Zip: Phone:
OW'I'tiIIER/:CONTRACTOR AFF1DVIT.App(ication:is.hereby made to:obtain a permitto do the work and installation as:indicated.::
i:certify`that no work car nsYatiation fins commenced prlor-to the issuance c fa permit:.
St..Lucle County makes no representation.that is granting a permit will authorlie the ermit:holder to,build the subject structure
which is in confiictwith any.applicable,Horne Owners Association rules,bylaws'or and covenants that may restrict or-prohibit-such
structure.Please consult w th your Horde Owners Association and.review.your deed for any.restrictions Which may apply.
in consideration of the granting.of this req"uested'perrnit;.tdo hereby agree that f will;in..a,ll respects;perform the;work
in.accorda nce with th approved plans;the Flori&Zu'sldirig Godes and,St-Lucie county A.mendriients..
The:foliowing-building permit applications are exemptfsorn undergoing a fulfconcurrency review:room additions,
accessory structures,swimming pools;fences,walls;signs,screen rooms and access,y uses`to.ariothei non-residential use
WARNING TO OWNER:Your failure:to.Record:a-Notice of t6mmencentent may result. r paying twice for
improvements to your pr Notice of Commencement must be recoriJed d lia don the jo6site
before the first inspe n, If'ya :intend to:obtain flnalicing,consul th lender orae a rney,5efore.
comm
wor .or ecordi` our Notice+af Ctimrriencefxlent.
Y 2w'�
gnature uiner/Agerit/Lessee gnature of ntrattiDr/Lfcen a Hdlder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �4-, 1.,C4,{' CCiuNT1'C1F > €C_i'£
fid forgoing instrument was acknowled ed before me The forgoing instrument-was acknowledged before me
th 'e3ayof` 2t} by: thi 2fayof cl�T 2omby
kenz
(Name.of per acknowledging): (Name of person ac , wiedging j
(Signature of Notary Pu/blit State.of Florida) (Signature of Notary:Public-Stat, of'Florida.)
Personally.Known 4/ OR Produced Identification Personally Known.ti!. 4it-Produced identification .
Type'of Identification Produced Type of identification Produced.
cclff Ymisslo a�a++pus,,', HOORAH%` LL ' Commission N
+o+ r 4' OE80RAW%QSELL
Notary Public State of Florida =♦� '°•: Notary Public State of Florida
Cammissron
'Revised 1� f`�4 My Comm.Expires Nov 30,2018 ;�, °=' My Comm.Expires Nov 30.2018
"0 i i��`'`
REVIEWS. FRONT ZONNG SUPERVISOR PLAINS VEGETATION SEA TURTLE MANG.RO.VE.
DATE.
COUNTER REVIEW REVIEW` REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE .
COMPLETED