HomeMy WebLinkAboutMECHANICAL/HVAC RESIDENTIAL- REPLACEMENT SYSTEM PA
Nov 0617 02;36p
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
PERMIT APPLICATION
FOR:
�yTo Select from dropbox, click arrow at the end of fine
Legal Description:'IOZS"- ? '.IVER, LROt; 9fi hLAPG S 01JIT V5 Wh t VbJVJHhPf-iu coukiiot')F(U1 /irjS
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Property Tax ID#: �ISOa-8a-L( -00"a `-002 Lot No.
Site Plan Name: Block No.
Project Name: �u LT C K,E0
Setbacks Front Back: Right Side: Left Side:
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Additionalwork to e e Orme under this perm -check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
01lectric Q Plumbing Sprinklers 1i Generator Roof L ! Roof pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$4 oo UU Utilities: Sewer F]Septic Building Height;
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Name Name: .
Address: t 51`1 Sir.?iri�r� .titlZ�,�Jf � WS Company: P
City: -Z� -e,rs NCT-K Stater Address: 3'� QQ #I6
Zip Code; SgCl n Fax: City: �'t-r-!S4- , ,� State4—_ —
Phone No. Zip Code':(. qqq& Fax: TIQ -35
E-Mail: Phone No. -7`7;Z -'9 I SLoQ
Fill in fee simple Title Halder on next page(If different E-Mail: ,Se- '"e1
from the Owner listed above) State or County License:
I f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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Nov 0617 02:36p
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DESIGNER/ENGINEER: Not App licabie� MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: � Not Applicable BONDING COMPANY: 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 is in Conflict with any applicable Nome 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
commencin r recordi ur Notice of Commencement
_Signature of Owner/Lessee/Agent Signatureof�ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDAJ� UA
COUNTY OF trt C-�E.L 'C�•l C'_� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 06 day of No�E•mb" - 20 L-1-by this(4o day of i•)oje.m-o1 20 12-by
(Name of person acknowledging) (Name of person acknowledging)
&- o
(§gnature of Notary Public-State of Florida j t lg ature of Notary Public-State of Florida}
Personalty Known OR Produced Identification Personally Known L'� OR Produced identification
Type of identification Produced Type of identification Produced
Commission No. '�'��t G�''t l.iN AFIIE BUUCHAFt Commission No. ��*F;; X I IIJDA MAft4l CHARD
`•i " MY COMMISSION#FF125528 '•'` •'
''� tj MY COMMISSION#FF125526
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