HomeMy WebLinkAboutBuilding Permit Application From:Alex Lopez Fax:(772)621-5959 To: Fax: (772)462-1578 Page:'3 of 4 1110812017 3:53 PM
. ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date,• 11/08/2017 Permit Number., ,I
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 X
PERMIT APPLICATION FOR: Mechanical
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Address: 138827 S INDIAN RIVER DRIVE
Legal Description: LAKE MANOR PARK COOPERATIVE SiTE 24(OR 1327_960, 1438-2886)
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Property Tax ID#: 4509-805-0024-000-9 i Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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AJC INSTALL: SEER 14l GROUND/3TON 15KW
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rtlona war to e e Orme un er t �s perm t=c ec a app y:
HVAC Gas Tank ❑Gas Piping _Shutters [ ,Windows/Doors
�Elettric 0 Plumbing ❑Sprinklers Generator QRoof Roof pitch
Total 5q. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 4665.00 Utilities: Sewer 17 Septic Building Height:
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Name EDWARDÐEL ROTHROCK Name. DON MIRANDA'
Address:2550 SE CHARLESTON DRIVE Company: MIRANDA PLUMBENG&AIR CONDITIONING
City: PORT ST.LUCIE State:FL Address: 760 NW ENTERPRISE DRIVE
Zip Code: 34952 Fax: City: PORT ST.LUCIE State:FL
` Phone No. _ Zip Code: 34986 Fax:
` E-Mail: Phone No. 772-878-1523
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Fill in fee simple Title Holder on next page(if different E-Mail: alopez@a mirandaoompanies.com
from the Owner listed alcove) State or County License: CACi815486
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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From:Atex Lopez
Fax:{772}621-5859 To: Fax: (772)462-1578 Page 4 of 4 1'110812017 3:53 PM
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DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: _ Name: - _
Address: Address: ,
City: - State: City:. __ State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: ,,._,_,Not Applicable
Name: Name:
Address:750 NW ENTERPRISE DRNE Address:
City: City:
Zip: Phone: Zip: Phone:
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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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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
com ng work or recording our Notice of Commencement. _
Sigrtatur:of Owner/Lessee/Cantractdr as Agent for Owner Slgnatu ka ffl.Contractor/License Holder
STATE OF FLORIDA .�- STATE OF FLORIDA
COUNTY OF COUNTY OF--
The
F _The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Zrk day 201_ his
by t , day of 1S Lt ,20a byjf��
Name of person making statement Name of per on making statement
Personally Known_e.4 OR Produced Identification Personally Known OR Produced Identification
Type of Identification _ _ Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida}
Commission No. C� _i is seal) Commission No. i Cr 1 i '4 {(Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAJURTLE MANGROVE
f COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
LCOMPLETED
Rev.8JLogi i7lodatl0
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Ccrll0*10n i GlGG $ ContfnisajnMGGOOM
• s fnk w Feb. 9, 2021 its: Feb. 9, 2021
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