HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/2512017 Permit Number:
s
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: 21 Nettles Blvd
Legal Description:
Parcel I D # 4502-501-0207-000-2
Property Tax ID #:
Site Plan Name:
Project Name: __._
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out 2 ton 15.5 seer Rheem heat pump split system 5 kw heater like for like
Lot No.
Block No.
Additional worKto be errormeci underthis permit—checK all apply:
HVAC Gas Tank []Gas Piping _ Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator u Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 4800.00 Utilities:ll Sewer E]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Douglas Moran
Name: Vance R Corbin
Address: 21 Nettles Blvd
City; Jensen Beach State: Fl
Zip Code: 34957 Fax:
Phone No. 613-607-2168
E -Mail:
Company: Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
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
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:
Address:
MORTGAGE COMPANY: x Not,Applicable
Name:
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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counter 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 vour Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 1
Theforgoing instrume t was acknowledged efore me
this °�'S day of ` ��'' ,�- 20 1' by
(Name of person acknowledging)
uv� �_Lk a-6
(Signature of Notary PgfSlic- State of Florida)
Petsflr�a+ly-iCn iafi // OR Produced Identification
-Type of JdZn Mcf ticn Produced
`Camrriission No ` Fa
ECHIE
f .
,-� fNY ®� •, SUZE
-p_= ° EXPIRES December 12, 2017
-Revised-017J
may) 398 553 FloridallolaryService com
s
Signature of Contractor/License Holder
STATE OF FLORIDA a
COUNTY OF
The forgoing instrume was acknowledged before me
this day of20 by
(Name of person acknowledging)
(Signature of Notary Pu ic- State of Florida)
Personally Known OR Produced IdeniAeaticrl
Type of Identification Produced
Commission No. (5Eai1 T,
SULPETTE
RITCHIE--:,
MY COMMISSION #FF061868
n�cQ?.•.a EXPIRES December 12, 2017
_
4b7 398
0153 Oridn Not
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