HomeMy WebLinkAboutBuilding Permit Pg.2ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
w� z ,aa�avu
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
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 18 Madrid Lane, Port St. Lucie, FL
Legal Description: Tangible Personal Property
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front
001603
Commercial Residential x
Back: Right Side: Left Side:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
AC CHANGE OUT LIKE FOR LIKE SYSTEM. 3 TON PACKAGE UNIT 14 SEER WITH 10KW HEAT.
MODEL # WJA43600ODTPOA
CONSTRUCTION INFORMATION:
Additional work to(e Performed under this permit — check a that apply:
✓HVAC L _I Gas Tank nGas Piping _ Shutters Windows/Doors
11 Electric F]Plumbing 11 Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor: _
Utilities: 4 Sewer F] Septic
Building Height:
OWNER/LESSEE: _
CONTRACTOR:
Name EILEEN PARR
Name: KENNETH H. GEARY
Address: 18 MADRID LANE
Company: BREATHE HEALTHIER AIR
City: PORT ST LUCIE State: FL
Zip Code: 34592 Fax:
Phone No. 772-342-5257
Address: 3669 SE SALERNO ROAD
City: STUART State: FL
Zip Code: 34997 Fax: 772-781-4634
Phone No. 772-221-8698
E -Mail: eileen_parr@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: tracy@breathehealthierair.com
State or County License: CAC035593
it value of construction is g500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: EILEEN PARR
MORTGAGE COMPANY: _ Not Applicable
Name: KENNETH H. GEARY
Address: 18 Madrid Lane, Port St. Lucie, FL
Address: 18 MADRID LANE
City: _PORT ST LUCIE State:
Zip: Phone_
City: STUART State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
_
Address: 3669 SE SALERNO ROAD
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 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.
Rev. 8/2/17
74646
Sig ature of Owner/ Lessee/Contractor as Agent r Owner
Signat-' e of Contractor/License Hol er
STATE OF FLORIDA,,
STATE OF FLO
COUNTY OF��
COUNTY OF !` _
The r g inst + �n,_t, �was acknowledged before me
�4—,
The1g inst m nt as acknowledged before me
��—,
thi ay of 201-1 by
thi� day of 20L% by
�CMCA n"
Name of person making statement'
Name of person making state ent
Personally Known OR Produced Identification V/
Personally Known OR Produced Identification
Type of Id ptifica .o.
'
Type of Idenificati n !'
Produced
Produce
1
S' tur of otary Public State of Fsq�,► ) Zuk L
S' re o Notar Public- State of FI: R��a eiy_ Zukkeyd
`b
My COMMISSIO
Commission No 1 LP9:j MyCommisslonrlission NoM I � "� ( February 20
i February
'�w
or 20,
'aOpr'p�
2021 Con wesiilm No.
CORlmissIon No.
G G 74646
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
74646