HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/17/2017 Permit Number:
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 x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 14313 Dulce Real
Legal Description:
Property Tax ID #: 414 %J&A 'p Lot No.
Site Plan Name: Block No.
Project Name: Zimmerman
Setbacks Front Back: Right Side: Left Side:
AC Change Out Previously Done By Others - We Are Pulling Permit For An Inspection Only.
Haamonai worK to oe ertormea unser tnis permit— cnecK allapply:
HVAC Gas Tank ❑Gas Piping Q _ Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers ® Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ UNKNOWN Utilities: 0Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Paul Zimmerman
Name: Michael Boyle
Address: 14313 Dulce Real Avenue
Company: Dynamic Air Quality & Cooling Systems, Inc.
City: Ft. Pierce State:FL
Zip Code: 34951 Fax:
Phone No.
Address: 1120 17th Street
City: Vero Beach State: FL
Zip Code: 32960 Fax: 772-567-2186
Phone No. 772-567-2185
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: dynamicair.1120@gmail.com
State or County License: CAC1818454
it value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMOION.
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: XX Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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.
y /
St. Lucie County makes no representation that is granting a permit will authorize thepermit 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.your Notice of Commencement. /�
Signature of Ow—ner�e/Contractor as Agent for Owner I Signature of Coptffiftor/License H
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF �1d11R14ef _
The fo ing instru �ery}t, was acknowledged before me The forgoing instrument was acknowledged before me
this day of X/dP r%L_P_,- , 20 /lby this " day of January 20 17 by
; C/k� 'C../ Michael Boyle
(Name of person acknowledging (Name of person acknowledging )
(Sign re of Notary Public- State of Florida) (Si ature of Notar Public- State of Florida )
Personally Known _X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
H. Ballou
Commission No. (S J Commission No. �' Y �Y PUBLIC
Cynet�il� H. Balkw
„ NOTARY PUBLIC STATE OF FLORIDA
Revised 07/15/2014 �-v _ COMM# FF951618
Expires 3/8{2020
Expires 3/8/2020
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