HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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 xxx
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 83 CAMINO DEL RIO, PORT ST LUCIE 34952
Legal Description:
Property Tax ID #: __ 1 ! (J --b2!- Lot No.
p
Site Plan Name: Block No.
Project Name: LAVOIE INSTALL
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE AC CHANGE OUT.
PACKAGE UNIT, NU`TOONE P7RD-048K, 14 SEER, 10 KW
0
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit— check allapply:
HVAC Gas Tank []Gas Piping M Shutters Windows/Doors
11 Electric 0 Plumbing U Sprinklers 11 Generator E]Roof �J Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4680.00
S Ft. of First Floor:
Utilities:0Sewer 7Septic Building Height:
OWNERAESSEE:
NameGERARD LAVOIE
Address: 83 CAMINO DEL RIO
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No.863-605-0101
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: PHILIP NISA JR
Company: NIS AIR AC
Address: 3700 S US HIGHWAY 1
City: FORT PIERCE
Zip Code: 34982 Fax:
Phone No. 772-466-8115
E -Mail: KRISTIN@NISAIR.COM
State or County License: CAC041199
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
State:FL
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State: _
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: 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.
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
improvements to your property. A Notice of Commencement mustb ecorded and posted on the jobsite
before the fist inspection. If you intend to obtain financing, consul Wi Y lender or an attorney before
commencing Work or recording your Notice of Commencemen .
It s
Signature f Owner/Lessee/Contractor as Agent for Owner Signature o? Contrad#or%License Holder
STATE q FLORIDA STATE OFlLORIDA
COUNTY/OF STLUCIE COUNTY F gTLUCIE
The or oing instr3Went was acknowledged before me
this of ti20 L-1 by
PHILIP NISA JR
(Name of, person acknowledgin
p r'
A t7�L�
_X
(Sig ature of Notary Public- State of Florida )
Personally Known xx OR Produced Identification
Type of Identification Produced
Commission No, FF201485
Revised 07/15/2014
REVIEWS I FRONT
COUNTER
DATE
COMPLETE
INITIALS
The forgoing instrument was acknowledged`before me
this 27TH day of FEBRUARY 203 ��9 by
PHILIP NISA JR
(Name of person acknowledging j A F 1
I
J_(Sinature of Notary Public- State of Florid4,a )
Personally Known xx OR Produced Identification
Type of Identification Produced
!Coal)
'Z9—mission NO. FF201485
(Seal)
KRISTIN 1BA1°CBHE3T
t N &G7 14;i�i
_
KRISTIN SAt'THOL7S
•
,, ,
_CXPJRtt Fe6ki6rY %2Q19
_
• «
c►r
Mr UpMNJI IQA! IIF q
EXPIRItb Fj �...
14071398-01 53
nterv9„rwoo.cna,
FtorldeN„
i �407).398�fl1,9i1„
t i.
..
,„ ,, Wig^ r+orn
ZONING
SUPERVISOR PLANS
VEGETATION SEA
TURTLE MANGROVE
REVIEW
REVIEW REVIEW
REVIEW REVIEW REVIEW