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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:I �c� I L� 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 PERMIT APPLICATION FOR: Mechanical PROPOSED INPROVEMENT LOCATION: Address: � G" % d c - —, 5 Legal Description: Iag, C:) Q_1" Property Tax I D #: 4 I L4 -I (-,ESO - J Lot No.��-� Site Plan Name: Block No. h Project Name: _ LQ ►�Dr7 Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: xGt ces� I a6e rn f [CONSTRUCTION INFORMATION: Additional work to e e orme under this permit - c ec a t appy: HVAC � Gas Tank []G as Piping _ Shutters Windows/Doors 11 Electric 2 Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: Lf -7 q Sq. Ft. of First Floor: Cost of Construction: 5 3,9 Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: MICHAEL EWING Address: jf)064,r-) bj - it P/0,5 Company: PIONEER COOLING & HEATING City: ti State: FL Address: 585 NW MERCANTILE PLACE # 106 Zip Code: j"1 Fax: City: PORT ST LUCIE State: FL Phone No,L': 72,5Q L2, Zip Code: 34986 Fax: E -Mail: Phone No. 772-579-9209 Fill in fee simple Title Holder on next page ( if different E -Mail: pioneerheatingco@bellsouth.net State or County License: CAC1817251 from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. r. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: Address: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I 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 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. Signature of Owner/ ent/ Lessee STATE OF FLCTRI A COUNTY OF f•}—/ , IIr�t° The forgoing instrument was acknowledi4tda before me this `s'wtlay of 20by Signature of Contractor/Li ense Holder STATE OF FLORIDA ` COUNTY OF —,-) f L t ti'a e� The for oing instrument was acknowledged before me thii1ay of 20©by IT i O E�Li n�a 1 t &� (Name of person acknowledging) I (Name of person acknowledging ) (Signature of Notary Public- State of Florida) e Personally Known ✓ OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida ) Personally Known �OR Produced Identification Type of Identification Produced Commission No. a Commission No,, . • �l� % VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW FRONT COUNTER ZONING REVIEW RAH RUS „ DEBORAH RUSSELL Nowy Puelic - State of Florida Notary Public - State of Florida ?J . . J,: Revised Ui/1 = Commission # FF 179630 My Comm. Expires Nov 30, 2018 J; i OFfIA My Comm. Expires Nov 30, 2018 REVIEWS SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW FRONT COUNTER ZONING REVIEW DATE RECEIVED DATE COMPLETED