HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: (12` l '014las
t H�`
Building Permit Application
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 Residential ✓
PERMIT APPLICATION FOR:
Mechanical
PROPOSED IMPROVEMENT LOCATION:. ,
Address: (Qr�41CQ 1E) Ueoln DY WHO a0e)QXl each t—� �gSrl
Legal Description: PlAlGtrlfiS M IaA. Al -e Sea On'%k (DOVE
I
Property Tax ID#:4611-' sIQ�–�CLot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Sider
DETAILED DESCRIPTION OF.WORK: , 7P
Ac Chan e Ob-A (;)-S tLyl5-14-5'e-y- -7 KW
COuNSTRUCTIO.N INFORMATION: ' ' t
Additional work to be nertormed under tis permit—check all appy:
HVAC Gas Tank 0Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers 1:1 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:,
Cost of Construction:$ 3��3 Utilities:Sewer Septic ,Building Height:
I'
OWNER/LESSEE:` CONTRACTOR:'
Name U-_00 "6i
x 6i Name: =)�.��'`1d yloi UJI__nso
Address:�) l� Or Company: c�C��'�/lICL iii r ie� i CCi
City: Vb-My Vbwn State:� Address: cr)gS IWW ct
Zip Code: OV-765 — Fax:
�, City: (�lU0e1fC�GO:Q Stater
Phone No. �- 2 Zip Code: Fax:
E-Mail: Phone No. '� -MCE ,000 �+ Eb
Fill in fee simple Title Holder on next page(if different E-Mail: um i -i SM iC2aYY Vi co
Clfrom the Owner listed above) State or County License: COI��PI
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
i
i
I
SUPPLEIVIENTALCO_NSTRUCTION LIEN L'AW INFORMATION ,4
.d m x ,r d
110,
DESIGNER/ENGINEER: _Not ApplicableMORTGAGE COMPANY: , _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name:
Name:
Address: Address:
City: City:
Zip: Phone: Zip: hone:
I certify that no work or installation has commenced prior to the issuance of a permit. lJ
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
impFQ,vements to your property. A Notice of Commence ent must a recorded and posted on the jobsite
b e f%Nhe I inspection. If you intend to obtain finan 'n c It th fender or.an attorney before
coin w k or recordingour Notice of Commend m n .
I '
_ I s
<Sigriature'of- r/Lessee%Contractor asAgent.for Owners Sig'nafu- -of- o. ract ir,/Lfctens_eEllvldefy
— i
STATE OF FLOfI�A �p STATE OF FLORID�
COUNTY OF Ic " COUNTY OF k9l rQ Walk
The fQ�r oing instrr e t wasacknowledge before me The fo oing ins ru( eint wa acknowledged before me
this f day of Iy � � 20 ��by this 'm day of20 _&7 by
1 t Yd VinBD� (YIiC� r ;vi nson
(NamJopers n acknowledging) j(Na f p r n acknowledging)
- h eft N d
ha re o N ry Public-State of Florida) gna ure of tary Public-StaI te of Florida)
Personally Known x OR Produced Identification Personally Known X, OR,Produced Identification
Type of Identification Produced Type of Identification Produced
SPRY PUB Now Shenek�����dy Commission tPaY°fie Sheneka HJ&dP1)„
Commission N o
Public- of Florida v
2 � Notar'.y Public-State of Floflda .�r
N e Commission#GG 33870 N e Commission#GG 33
rForFExpires 9rFo�F�o2 ;Expires;9/27/2020
Revised 07/
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION { SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS i
J i ,