HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/6/2017 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 x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 12455 SE Harbour Ridge Blvd 2-5, Palm City, FL 34990
Legal Description: POND APPLE VILLAGE UNIT 2-5 (OR 663-1230; 2157-907)
Property Tax ID #: 4425-620-0013-000-5 Lot No.
Site Plan Name: Francolini Block No.
Project Name: Flynn's AC Services
Setbacks Front Back: Right Side: Left Side:
Replace a 2.5T, 14 seer A/C system with 5KW HTR
IJ HVAC L__J Gas Tank
11 Electric 1:1 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4075.
Name Theresa Francolini
na—Lnecrc an mai appiy:
Piping Shutters
nklers L Generator
S Ft. of First Floor: _
Utilities: Sewer ❑ Septic
Address: 12455 SE Harbour Ridge Blvd 2-5
City: Palm City State: FL
Zip Code: 34990 Fax:
Phone No. 772-324-8519
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Joseph Flynn
❑ Windows/Doors
❑ Roof ❑ Roof pitch
Building Height:
Company: Flynn's AC Services
Address: 1323 SW Thelma St
City: Palm City State: FL
Zip Code: 34990 Fax: 772-781-1307
Phone No. 772-283-4114
E -Mail: mjb@flynnac.comcastbiz.net
State or County License: CAGO55482
construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City: State:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
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 conflictwith 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
commencine work or recordine your Notice of Commencement.
_
Signa t r of Ow r/ Lessee/Agent
STATE OF FLORID
COUNTY OF FLORIDA
%L
The forgoing instrument was cknowledged before me
this day of �, 20 llaby
STATE OF FLORID
COUNTY OF >�r�1�, -1/I
The forgoing instrument was a-knowledged before me
this _L� day of 20 -0- by
(46
(Name(6f person .cknowledging I (Name of person bcknowledging )
&" _Q�=
( ignature of Notary Public -State of Florida) (Signature of Notary Public- ate of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
IM
J. Brown
Commission No.��NOTMpUSLIC
STATE OF FLORIDA
Revised 07/15/2014 _+CF"l- E)PIrM 40/1112020
Personally Known 'OR Produced Identification
Type of Identification Produced
Commission No. JW466 W&V''FlB BIJ C
STATE OF FLORIDA
14"' 1af/POYO
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