HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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DESIGNER/ENGINEER:
Name:
Address:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
Not Applicable
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
City:
City:
Zip: Phone:
Personally Known Lam'" OR Produced Identification
Zip: Phone:
Type of Identification
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
commencing work or recording your Notice of Commencement.
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Signature of owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA <)
STATE OF FLORIDA`��
COUNTY OFti ti Cts
COUNTY OF
The for oing instru ent was acknowledged before me
this day of � �- 20 by
The forgoing instr ent was acknowledged before me
this % day of 2041 by
Name of person making statement
Name of person making statement
Personally Known Lam'" OR Produced Identification
Personally Known 4- " _'OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Pu I - lorida)
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Commiss Suzette Ritchie rSea
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/4/2018 Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade 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: 251 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0437-000-3
Property Tax ID #:
Site Plan Name: _
Project Name:
Setbacks- Front
Back: Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: i
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
CONSTRUCTION INFORMATION:
Additional work to be berformed under this permit — c ec a app v:
HVAC Gas Tank ❑Gas Piping
11 Electric Plumbing 1:1Sprinklers
Total Sq. Ft of Construction: ____
Cost of Construction: $ 3800.00
L] Shutters 11 Windows/Doors
Generator 0 Roof Roof pitch
Sq. Ft. of First Floor: _
Utilities:0 Sewer ESeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David McDonald
Name: Vance R Corbin
Address: 251 Nettles Blvd
City. Jensen BeachState: El
Zip Code: 34957 Fax:
Phone No. 513-267-0356
E -Mail:
Company: 'Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: Fl
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: doddenterprises@dodd_com
State or County License: CMC1249958
IT value or construction is:.&)UU or more, a iitc:UKULD Notice of Commencement is required.