HomeMy WebLinkAboutBuilding Permit Application {
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j ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
� Date: Permit Number:
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Building Permit Application kl
Planning and Development Services j
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34981 "' f
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR! Mechanical
PR }P '..SEDI`fUIP ®1/E,
Address: 76 Aqua Ra Dr Jensen Beach, FL 34957
Legal Description: WINDMILL VILLAGE BY THE SEA-UNITTWO-BLK A LOT 14-LESS E 36.97 FTII(OR 519111937;1&05-1221 ;1822-338:2006-579)
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4511-811-0015-010-2Propert y Tax ID
Lot No.
Site Plan Name: ! Block--No.
Project Name: Glen Meierdiereks
Setbacks Front Back: Right Side: Left Side
'.I.€ _,i I.!'.+ 1 M1, 411111 iTWQRK� 10
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'A/C CHANGE OUT OF A RUUD SYSTEM
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kt,CONSTRUCT�ONa1NFORMATION. �rk � �
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Additional work to be ertormed under tIs permit—check all that appy: {
7HVAC Gas Tank E]Gas Piping _Shutters !I. Windows/Doors
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Electric Plumbing Sprinklers []Generator 11 Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor-1'l
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Cost of Construction:$ 3050 Utilities: _Sewer ElSeptic ;'Building Height:
Name Glen Meierdiercks Name: GRETA B SMITH11
Address:76 Aqua Ra Dr Company: ALL YEAR COOLING AND HEATING
City: Jensen Beach State:FL Address: 1345 NE 14TH AVE
Zip Code: 34957 Fax: City: FORT.LAUDERDALE State:FL
Phone No. Zip Code: 33304 I Fax:
E-Mail: Phone No. 954-566-4644 :! j
Fill in fee simple Title Holder on next page(if different E-Mail: DDANIELS&YCAI,R.COM
from the Owner listed above) State or County License: CAC058160
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address: I I,
City: State: City: I I;;' i State:
Zip: Phone: Zip: Phone:!
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: (hone: !
I certify that no work or installation has commenced prior to the issuance of a permit. i
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 a'ny 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:lroom,additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
ii -iWARNING TO OWNER:Your failure to Record a Notice of Commencement may resu.I your paying twice for
improvements to your property. A Notice of Commencement must be recorded 'and posted on the jobsite
before the first inspection. Ifyou intend to obtain financing, consult with lender;o;r an attorney before
commencing work or recording our Notice of Commencement.
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S, nat a of Owner Lessee/Contractor as Agent for Owner Signatur Contract_ ense Ho er
ST OF FLORIDA STATE TF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF BRowARD L;j
- . The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this is day of DECEMBER 20 77 by this 15 day of DECEMBER 'i I !20 17 by
DIMITRIUS DANILS DIMITRIUS DANIELS
(Name of person acknowled ' (Name of on ac n�w ing)
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(Signature of Notary - eof Florid igna e o Notary, blit-State of Florida)
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Personally Known x OR Produced Identificp Ion ers nally Known x it OR Produced Identificat' ,
Type of Identification Produced Fes, '1 '� Yi' e of Identification Produced »:
Commission No. y; ep ��,�� ��� Commission No.
Revised 07/15/2014 _A
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION ,I EA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW ;; REVIEW REVIEW
DATE
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INITIALS I
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