HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
x Not Applicable
State
x Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY
Name,
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
x Not Applicable
State:
x Not Applicable
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.
Agent r n
Signature of Owner/Lssee/Contractor as gent fo Ow er
STATE OF FLORIDA' (U(UQ—
COUNTY OF
The forgoing instrume t was acknowledged before me
this day of 20 1by
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(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known i/ OR Produced Identification
Type of Identification Produced
GommissjomNQi " I e`a't• IIZETTE Ft�T HIE
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EXPIRES December 12, 2017
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_ - COUNTER REVIEW
DATE
COMPLETE
INITIALS
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Signature of Contractor/License Holder
STATE OF FLORIDA h
COUNTY OF *f. `Q 0AVI-1
The forgoing instrume t wascknowledged before me
this day of id�.Y.�- , 20 il_ by
(Name of person acknowledging)
_�5almk_/Akw
(Signature of Notary Public- State of Florida )
SUPERVISOR PLANS
REVIEW REVIEW
VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW
Personally Know
OR Produced
Identificatron __
Type of Identification Produced
Commi siafIldlc,.)
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SUPERVISOR PLANS
REVIEW REVIEW
VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date.. 4/612017 Permit Number:
ale
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: 659 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0845-000-6
Property Tax ID ##: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:'
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit —check all apply:
11
HVAC Gas Tank OGas Piping
Shutters L__ f Windows/Doors
aElectric ❑ Plumbing Sprinklers
[]Generator Roof Roof pitch
Total Sq. Ft of Construction:
SFt. of First Floor:
Cost of Construction. $ 3800.00 Utilities:I]Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Patricia Schaefer
Name: Vance R Corbin
Address: 659 Nettles Blvd
Company: Dodd Enterprises Inc
City: Jensen Beach State: Fl
Address: 1296 SE Industrial Blvd
Zip Code: 34957 Fax:
City: Port St Lucie State: FI -
Phone No. 772-249-4422
Zip Code: 34952 Fax: 335-3310
E -Mail:
Phone No. 398-2344
Fill in fee simple Title Holder on next page (if different
E -Mail: doddenterprises@dodd_com
from the Owner listed above)
State or County License: CMC1249958
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.