HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/09/2017
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 1904 ROSITA AVE
Legal Description: PARADISE PARK BLK 25 LOT 19 (OR 3816-34)
Property Tax ID #: 1433-701-0417-000-1
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE AC UNIT 3 TON 14 SEER 10 KW HEATER
Lot No. 19
Block No. 25
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—check allapply:
HVAC —Gas Tank []Gas Piping InShutters❑Windows/Doors
Electric 0 Plumbing ❑Sprinklers FIGenerator E]Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4090.00
OWNER/LESSEE:
Name WILAMRT SERVICE INC
Address: 1904 ROSITA AVE
City: FT. PIERCE
Zip Code: 34982 Fax:
Phone No. 4058815809
E -Mail: N/A
SQ. Ft. of First Floor:
Utilities: 0Sewer OSeptic Building Height: _
CONTRACTOR:
Name: KEVIN S MCCARTHY
State: FL
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Company: GLADES GAS CO INC
Address: 804 N PARROTT AVE
City: OKEECHOBEE State: FL
Zip Code: 34972 Fax: 8637632116
Phone No. 8637632114
E -Mail: VERONICA@GLADESAC.COM
State or County License: CMC054668
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State: _
Zip: Phone:
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 Countv makes no representation that is granting a permit will authorize thedpermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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 Comme icement.
S
Signature of Owner/Lessee/Cr/Iptractor as Agent for Owner Signature of Contractor/Lice`ns�Hplder
STATE OF FLORIDA IV1 STATE OF FLORIDAl///
COUNTY OF ()KF F—C i{o131EE COUNTY OF O IEkGt{013EE
The foroing instrument was acknowledged before me
this day of StLW 6 . 20 12by
Kc%jI r4 mc. Ct ouiAY
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
The forgoing instrument was acknowledged before me
this `I! day of N'" C 20 1 % by
K!Evl tJ Mc C+�.K- R>,
(Name of person acknowledging )
l�J �C>\sRm
(Sig ature of Notary Public- State of Florida )
Personally Known Y OR Produced Identification Personally Known A OR Produced Identification
Type of Identification Produced _.. - Type of Identification Produced
zo`;:•;1%0 LINDA W,COWEN +°` ' ;'o UNDAW,COWEN
Commission No. 2a659a galryCOMMISSIONiFF22E9tommissionNo. aa.b599L IMyCOMMISSIIN#FF2M?!
EXPIRES: May 8, 2018 EXPIRES: May 8, 2019
Banded ThruBAetNobrySery xa °?oo no°' BWWThru Bu*tNobryBeiyW
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS