HomeMy WebLinkAbout855 Nettles Blvd App OnlyALL APPLICABLE INF IMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L Permit Number:
CCO+l�*ITY _.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34.982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential X
I PERMIT APPLICATION FOR: Mechanical 11
I PROPOSED IMPROVEMENT LOCATION: II
Address:
% gwb
Q.
Legal Description: N�.�i u (S�l tt'L . ACQkh-SiLCA'10i,1 V` eALSI c U S—
Site Plan Name: S W�DS Lrj Block No.
4
Project Name:I. _ ._ �S t L&i 1 S
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replacing A1C, exact change out, no duct work with
AHVAC UGas Tank
LJ Electric 1:1 Plumbing
Total Sq. Ft of Construction:
Q se
—
Cost of Construction: $ L
3 ` lof 1 VL Suk # ko 1W
Gas Piping I__IShutters Q Windows/Doors
Sprinklers 11 Generator 3 Roof
5 . Ft. of First Floor: _
Utilities: Sewer E Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name S (
Name: zacek, Dennis
Address: JCJ lot
Company: American Residential Services
City: State:
Address: 2800 U5 Hwy 1
Zip Code: Fax:
City: Vero Beach State: FL
Phone No. 0.� , ` �� 3a`��
Zip Code: 32960 Fax: 772 794-9783
E -Mail:
Phone No. 772 794-7221
Fill In fee simple Title Holder on next page ( If different
E -Mail: bderby@ars.com
from the Owner listed above)
State or County License: CMC1249753
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Prone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count 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
commencing work or recording vour Notice of Commencement.
D
_ Signature of Ow r/ Lessee/Ag cnI Signature of Cont or/License Holder
STATE OF FLORIDA
COUNTY OF SL Lucie
The forgoing instrument was acknowledged before me
this 'IL day of ,J f NJ 20 4by
Dennis Zw&
person acknowlIM
BETH A DERBY
My COMMISSION A FF9%
STATE OF FLORIDA
COUNTY OF smucie
The forgoing instrument was acknowledged before me
this i day of 3 AQ . 20 X:�. by
Dennis Zacek
{Name of person ac edgin 0. '}'•f;;; BETH A DEI"
MY COMMISSION 41
.o. , • EXPIRES April 15
�ea��aos•o•sa fio..daNa,� s- ��
(Signature of Notary P ic- State of Florida )
Personally Known x OR Produced Identification Personally Known x' OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF220930 (Seal)
Revised 07/15/2014
Commission No. FF220930 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS