HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09--14 -l7 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 XX
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 5412 West Echo Pines Circle
Legal Description: HOLIDAY PINES S/D-PHASE I-LOT 115 (MAP 13/12S) (OR 3752-1503)
Property Tax ID#: 1312-500-0116-000-2 Lot No 115
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace a/c equipment, like for like. Rheem 5.0 ton 16.0 SEER with 10kw electric heat strips
CONSTRUCTION INFORMATION:
Additional work to be e orme m
under this perit—check all that apply:
LJnnHVAC Gas Tank DGas Piping D Shutters Windows/Doors
L lElectric Plumbing Sprinklers I Generator Roof
Total Sq. Ft of Construction: 5 Ft. of First Floor:
Cost of Construction:$ 4900.00 Utilities:n Sewer F-1 Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Kenneth Blackman Name: Wanda Gahn
Address:5412 West Echo Pines Cir. Company: AC Buddy, Inc.
City: Fort Pierce State: FL Address: 2451 Seminole Rd.
Zip Code: 34951 Fax: City: Fort Pierce State: FL
Phone No. 336-675-5860 Zip Code: 34951 Fax:
E-Mail: Phone No. (772)480-4136
Fill in fee simple Title Holder on next page(if different E-Mail: ACBUDDYINCr7a GMAILCOM
from the Owner listed above) State or County License: CAC181909
Ifvalue of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: xx Not Applicable MORTGAGE COMPANY: xx Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: xx Not Applicable BONDING COMPANY: xx 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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which ism 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, l 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 frill 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 our Notice of Commencement.
Signature of Owner/Le see/Agent ignature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF &- LLI Lies COUNTY OF St.Lucie
The far ing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this of 11 e� i`4 2u 17 by thisiq4ldayof � 20 by
f I YYl TY . #'f"} J r wands Gahn
(Nam/o;fe rson ackn owl edginjg (Name of erson acknowled ing j
( i nature of Notary Publi JState of Florida} (Si nature of Notary Public-State of Florida}
Personally Known tz' OR Produced Identification Personally Known 11Z OR Produced Identification
Type of Identification Produced Type of Identification Produced
lCris4ina R.Parsons
Commission No. (Seal) Commission No.
t Yq Kristina R.Parsons NOTARY�Ailk
NOTARY PUBLIC c STATE OF FLORIDA
STATE O
Revised 07/15/2014 coma#GG09MM Expires 4/23/2021
°NCE Ig1 Ex ires 412312021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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