HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/18/17Permit N umber:
-I1a_
- - - Building Permit Application
I •11
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
PROPOSED IMPROVEMENT LOCATION:
Address: 5049 N HighwayA1A Rd Apt 1904, Hutchinson Island, FL 34949
Legal Description:
Property Tax ID#: 1414-613-0089-000-3 Lot No.
r _
Site Plan Name: I r I Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side: I
DETAILED DESCRIPTION OF WORK: I
Changeout of a 3'ton water to air heat pump packaged system, like for like j
CONSTRUCTION INFORMATION:
Additional work to be nertormed under tispermit—check all t.hat appy: I
HVAC Gas Tank Gas Piping _Shutters I Windows/Doors
Electric ❑_Plumbing ElSpeinklers 0 Generator, T-R o of
Total Sq. Ft of Construction: Sq. Ft.of First Floor: i
! �
' Cost of Construction:$ 4550 Utilities: Sewer❑Septic ; ? Budding Height:
OWNER/LESSEE: CONTRACTOR!-'
Name Sandra Dube Name: James J.Muters
Address:-5049 N Highway A1A Rd Apt 1904 Company: Just CFiillin' HVAC LLC
City: Hutchinson Island State:FIL Address: 5422 NW Cromey St
Zip Code: 34949 Fax: City: PJt St. Lucie ; I State:FL
Phone No.508-667-5288 . Zip Code: 34986 Fax:
E-Mail: Phone No. 772-94,0-4373;,1
Fill in fee simple Title Holder on next page(if different E-Mail: justchillinair@hotinail.com
from the Owner listed above) State or County.License: 263261
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.,:
I
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:-
DESIGNER/ENGINEER: _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: 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 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.
Si nature of PneR Agent/Lessee S' nature of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF ,4
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�day ofa� 20 N by this (�day of 20_]_Z by
(Name o erson acknowledging) a (Name of per on acknowledging)
45ignaatlure2o:�fNotary Public-St a of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
LASHAHNA IPIGRAM
aI""''� Commission No.
Commission N ;�:—�9, �, racy public (S�ak)ot Florida r,
F.1y Comm.Expires Dec 20,201@ LASHAHNA INGRAM
11
r, _issinn,' FF 177249 `1tPA�\e G flnPaiV p,miir,-State of Florida
OF °:nded through National Notary Assn. J.
_My Comm.Expires Dec 20,201 S t)
Revised 07/-Alp _ —%� iN U r
- Irl F Commission FF 177249
%P,;,, 30nced through P!ational Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED