HomeMy WebLinkAboutBuilding Permit Application 0111112018 11:38 (FAX) P.0011004
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 4
Date: � ��- 115 Permit Number)lU - Oa`a
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EIVEDBuilding Permit Applicationi 1 t�J18Planning and Development ServicesBuilding and Code Regulation Division Pennitting2300 Vlrglnla Avenue,Fort Pierce FL 34981 Lounty,
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 2o� �
Legal Description: River Park-Unit 3-Blk 31 Lot 8
Property Tax ID#: 3419-515-0275-000-4 Lot No.8
Site Plan Name: Block No. 31
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC install k(o SP. v' 2--�=' S�e-Q
CONSTRUCTION INFORMATION:
A00itionalworktopenerformed under this perm -check all appy:
HVAC Gas Tank E]GasPiping _Shutters Windows/Doors
❑Electric Q Plumbing []Sprinklers U Generator Roof Roof pitch
Total Sq.Ft of Construction: Scl. Ft,of First Floor:
Cost of Construction:$ 6900.00 Utllitles: Sewer F-]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name 4- I(e-n Name:
Address:Z-0Q Company: AC Advantage Inc
City: QST-o_4_"__ State:FI Address: s+
Zip Code: 34952 Fax: City: P-,Zz( 1.1 C�� State:FI
Phone No. CS411 - Zip Code: 34984 Fax: 772-336-7566
E-Mail: Phone No. 772-336-7386
Fill in feesimple Title Holder on next page(if different E-Mail: csr@acadventagelnc.com
from the Owner listed above) State or County License: CMC1249807
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
01111/2018 11:38 (TAX) P.0021004
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:
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 Count makes no representation that Is granting a permit will authorize the ermlt holder to build the subject structure
which is in conflict with aHyl aapplicable Home Owners Association rules,bylaws gr an f covenants that may restrict or prohibit such
structure.Please consult w th your Home Owners Association and review your deed or 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 jobslte
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commepcing work or recording our Notice of CommencemerO
An-azure of Owner/Lessee/Contractor as Agent for Owner S' nature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _:5k COUNTY OFaL-ae
Theforgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me
this 7 day of�- �-20AD by this a day of J—wy 20A by
Scott Camire
Name of person making statement Name of person making statement
Personally Known �,Q—OR Produced Identification Personally Known xxx OR Produced Identifica
Type of identification Type of Identification
Produced r Produced . Q
(Sig ature of Nota Public-State of Florida) (51 ature of No ary Public-State of Florida)
ommission No. �� l�� Z- (Seal) Commission No. FF172282 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17