HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` �1
Date: °tom ��( Permit Number:
® RECEIVED SEP 2 ' 1011
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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 X Residential
PERMIT APPLICATION FOR: Mechanical ;_
PRUPOSEQ_'1MP,' ENT LOCATION
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Address: 8580 SOUTH US HIGHWAY 1
Legal Description: ST LUCIE GARDENS 26 36 40 BLK3 THAT PART OF LOTS 2,3,14 AND N OF SAVANNAH CLUB BY MPDAF FROM INT OF NW COR OF
LOT 2 AND N LI OF S 112 OF LOT 3 RUN S 89 54 28 W ALG N L1 329.81 FT TO W L1 OF LOT 3,TH 5 00 2102 E ALG W L1 241.02 FT TO ELY RD RAN Li OD
Property Tax ID#: 3414-501-1902-400-2 Lot No.
Site Plan Name: SPEEDWAY Block No.
Project Name: REMOVE AND REPLCE 15 TON RTU AC UNIT
Setbacks Front Back: Right Side: Left Side:
DETAILED D'ESCRIPTlONOF WORK
a
aC MdV6 Mtf-tfC4CE IS «At MOW PldCICA -& JCC C-emc1E 666-J'-UTr
CONSTRUCTION INFORlVIAT1ON: x f'
Additionalworkto e ,nertormed under this permit—check a appy:
FV�HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
DElectric 0 Plumbing Sprinklers FIGenerator F] Roof Roof pitch
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 22,264.90 Utilities:nSewer aSeptic Building Height:
OWNER/LESSEE ' l CONTRACTOR: G ;
s
Name HESS REALTY LLC%PROPERTY TAX DEPT. Name: SEBASTIAN MOORE
Address:539 S MAIN ST. Company: TWC SERVICES
City: FINDLAY State:OH Address: 7950 CENTRAL INDUSTRIAL DR.SUITE#101
Zip Code: 45840 Fax: City: RIVIERA BEACH State:FL
Phone No. Zip Code:-33404 Fax:
E-Mail: Phone No. 1(561)246-8542
Fill in fee simple Title Holder on next page(if different E-Mail: pat.mesmer@twcservices.com
from the Owner listed above) State or County License: CACI 815169
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CON TRUCT10 LIEN LAW IN ORMi4TtON d '
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: N a m e:SEBASTIAN J MOORE
Ad d cess:8580 SOUTH US HIGHWAY 1 Address:
City: State: City: RIVIERABEACH State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:7950 CENTRAL INDUSTRIAL DR.SUITE#101 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 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.l 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 otrcp of Commencement must be recorded and posted on the jobsite
before the first inspection. If you-i ten to obtain financing, consult with lender or an attorney before
commend n w or ecordin ' our, otice of Commencement.
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Signature of Owner/L s e/Contractor as Agent for Owner Signature of Contactor/License Holder
STATE OF FLORIDAS�,�t�N�C� COUNTY FLORIDA
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COUNTY OF Pia---
The for Ding instrur�e t as ack owledg before me The forgoing instrument was acknowledged before me
this day of J � �G1^ E_ 20� by this 18 day of SEPTEMBER 20_ by
SEBASTIAN J MOORE
Name of person making statement / Name of person making statement
Personally Known OR Produced Identification 1/ Personally Known OR Produced Identification x
Type of Identificati n Type of Identification
Produced �c%r O�Z�rE,� Lr�� Produced FLA DRIVERS ICENSE
(Signature f N tap 64662 (Signature '
PArRIGK STEPHEN MESMER
My Comm.Expires Jun 26,2021
Commission No. OFA WeditwONa(&rt}ykm Commissio !� ".�! u',eal
N. 04' I�+Im��lh,•,,y,pIr86UIm�. 1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17