HomeMy WebLinkAbout SLC Building Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/30/2017 Permit Number:
a
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: 8213 MAIDENCANE FL
Legal Description: LAKE LUCIE ESTATES PLAT NO. ONE(OR 3029-2123
Property Tax ID#: 3426-703-0130-000-5
Lot No. 116
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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A/C INSTALL: REPLACE LIKE FOR LIKE: SEER15 / 3.5 TON / GROUND / 9 KW
TElectric
na wor to e e orme un er t is permit—c ec a apply:
VAC Gas Tank ❑Gas Piping _Shutters Windows Doors
Q /0 Plumbing Sprinklers F]Generator Ei Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 7386.00 Utilities:�Sewer Septic Building Height:
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Name GIACOMO A. POLLARI Name: DON J MIRANDA
Address:8213 MAIDENCANE PL Company: MIRANDA PLUMBING&AIR CONDITIONING
City: PORT ST. LUCIE State:FIL Address: 750 NW ENTERPRISE DRIVE-#100
Zip Code: 34952 Fax: City: PORT ST. LUCIE State:FL
Phone No.772-332-0926 Zip Code: 34986 Fax:
E-Mail: Phone No. 772-878-5123
Fill in fee simple Title Holder on next page(if different E-Mail: alopez@mirandacompanies.com
from the Owner listed above) State or County License: CAC1815486
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: i Not Applicable 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:750 NW ENTERPRISE DRIVE 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
comme44r
Jngwork or reco.rding your Notice of Commencement.
Signatur�df Owner/lessee/Contra—etor as Agent for Owner Slgnatu a ontractor/License Holder
STATE OF FLORIDA c..f STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_. day of i;4-�O✓`:M ',20Z by this day of v14 rtfs--(Z- ,201) by
Name of person making statement Name of per on making statement
Personally Known_ / 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. ChAcu_ I i?ti .�Ht> (JSeal) Commission No. SAC t k?-,,l`;148 :a(Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
LOO D'wdato .' Loll Mato Cornmissian#GGIOt�258 Comminion#GG069258
s Expires: Feb. 9, 2021 irm Feb. 9, 2021