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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 4/19/2017 Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2.300 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: 389 Nettles Blvd Legal Description: Parcel I D # 4502-501-0575-000-2 Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Change out 31 ton 14 seer Payne st cool pkg unit 8 kw heater like for like Lot No. Block No. CONSTRUCTION INFORMATION: Additional work to be ertormed under this permit— cleck all apply: HVAC Gas Tank F] Gas Piping Shutters ❑ Windows{floors Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: _ Cost of Construction: $ 3800.00 SFt. of First Floor: _ Utilities: Sewer E]Septic Building Height: OWNER/ LESSEE: CONTRACTOR: Name James Brown Name: Vance R Corbin Address: 389 Nettles Blvd Company: Dodd Enterprises Inc Address: 1296 SE Industrial Blvd City. Jensen Beach State: FI Zip Code: 34957 Fax: Phone No. 772-229-0171 City: Port St Lucie State: FI Zip Code: 34952 Fax: 335-3310 Phone No. 398-2344 E -Mail: doddenterprises@dodd.com E -Mail: Fill in fee simple Title Holder on next page ( if different 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: x Not Applicable Name: MORTGAGE COMPANY: xNot Applicable Name: Address: City: State: Zip: Phone: Address: 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 w6rk 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 commenciniz work or recording your Notice of Commencement. y. L V f s Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF i, UL The forgoing Instrum t was cknowledged before me this day of 20 L[by (Name of person ackhowledging ) STATE OF FLORIDA COUNTY OF 4z W_&V_, The forgoing instrujilnent.,was acknowledged before me this A day of 20 ' 4._ by (Name of person acknowledging) (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of_Identification Produced Type of Identification Produced y a Cprrtnirssion N eCam �I (Seal) _V SI„I�>ETTERT L` IE �P��PU�;• �UZFTTF ION #FF061868 �� � . "'=.AV 15610N #FF061868 2017 XpIRES December 12, 2017 N;J � EXPIRES December 12. s� RecviSi 9(y r ce•oom FloridallotaryService.camnorldalloiaryServi2`01 t407! 393-0153 REMl'WS- '.FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE _ 'COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS