HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 1 —�"d Permit Number:
510
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 xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROP;QSED I,MP.ROVEM,ENT LOCATION
Address: 354 European Lane
Legal Description: Palm Grove
Property Tax ID#: 3410-503-0191-000-7 Lot No.2
Site Plan Name: Block No. G
Project Name: Kiley, Barbara
Setbacks Front Back: Right Side: Left Side:
D'��TAILED 17ESCRIPTIONOF-WORK .�
A/C Change out Carrier 3ton 14seer 4KW 25HBC536/FV4CNF002L
CgNSTRUCTI.ON 1NFORM—11 .NO
Additional work to a performed under
this permit—c ec a appy:
, ._
HVAC � .
'
Gas Tank EGas Piping _Shutters Windows/Doors
Electric 11PlumbingSprinklers E Generator F] Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 5699.00 Utilities:cn Sewer[]Septic Building Height:
iOWNRER/LESSEE CONTRACTOR
Name Kiley,Barbara Name: Jeffrey Lindstrom
Address: 324 European Lane Company: Lindstrom Air Conditioning
City: Fort Pierce State:FL Address: 3581 W McNab Rd
Zip Code: 34982 Fax: City: Pompano Beach State:FL
Phone No. 772-577-4148 Zip Code: 33069 Fax:
E-Mail: Phone No. 772-600-4088
Fill in fee simple Title Holder on next page(if different E-Mail: dulcem@lindstromair.com
from the Owner listed above) State or County License: CAC056971
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LEEN LAW INFORMATION
.
.amu
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
N am e: Kiley,Barbara N a m e:Jrffrey Lindstrom
Add res$:354 European Lane Address: 354 European Ln
City: FortPierce State: City: Pompano Beah State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 3581 W McNab Rd 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 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 Commence93"t may result in your paying twice for
improve nts o your property. A Notice of Commencement m t b recorded and posted on the jobsite
before e first nspection. If you intend to obtain financing, co suit ith lender or an attorney before
comm ncin first
k r ecordin our Notice of Commenceme t.
SignrEOF
of ner/Lessee/Contractor as Agent for Owner Signa ur of Contractor/License Holder
STA FLORIDA a ST OF FLORIDA / ,
COUNTY OF C.C-Q COUNTY OF ,StuLtP
The forgoing instrument was acknowledged before me The forgoing instrume t was acknowledged before me
thisc�day of ,20j-) by this—L day of I ' 201� by
Name of pers n @king statement Name of per n making statement
Personally Known R Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produc Produ
di
(Si nature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
DULCE MARTINEZ Y�u DULCE MARTINEZ
) Commission No�'��'"'�O Itselon#GG1 Ml
Commission fro. Comm ntr`GG1��� � )
Expires May 10,2021 1 * Expires May 10,2021
For rL�p Bonded ThN Budget Notary Servlcee 1.
Ur 1Ive�� Bonded Ihru Budget Notary Swue
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17