HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/13/2017 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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S. Ocean Dr. #604
Legal Description:
Parcel I D # 4511-805-0005-000-7
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Property Tax ID #: Lot No.
Site Plan Name:
Project Name: _.__
Setbacks Front
Back: Right Side: Left Side:
Block No.
IDETAILED DESCRIPTION OF WORK: 1
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
CONSTRUCTION INFORMATION:
Additional work to be
ne orme under tispermit—check all appy:
HVAC L_I Gas Tank Gas Piping _ Shutters Windows/Doors
QElectric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 3800.00
S Ft. of First Floor: _
Utilities:Sewer 0Septic
Building Height:
OWNER/LESSEE: _
CONTRACTOR:
Name Beverly Bernstein
Name: Vance R Corbin
Address: 10701 S. Ocean Dr. #604
Company: Dodd Enterprises Inc
City: Jensen Beach State: F1
Zip Code: 34957 Fax:
Phone No. 772-229-1480
Address: 1296 SE Industrial Blvd
City: fort St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: doddenterprises@dodd.com
State or County License: CMC1249958
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If value of construction is $2506 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: K 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:
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. r
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
commenciniz work or recording vour Notice of Commencement.
ILL
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA jj ,, ,,
COUNTY OF r COUNTY OF �c,{C_ 'c'
The fo'r�oing instrume t was a knowledged before me The forgoing instru nt was acknowledged before me
this I, . day of 20 4by this day of E 20 I by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Nota
rykPubli - State of Florida }
Personally Known 1/ OR Produced Identificatiao
Type of Ident a: egg; ,,ro u eft
Commission No
R�yised OV_152014
MY COMMISSIO�aro5186s
EXPIRES Decent er '12, 2017
(Signature of Notary7OR
State of Florida) _ ti
Personally Known Produced Identificatiop-
Type of Identification Produced
tea ,No. 69ZETTE SITGiE�IE Se311
x MY COMMISSION
F06186H
, 2017
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