HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:(
Name:
Not Applicable
'BONDING COMPANY: XNot Applicable
Name:
Address:
Address:
City:
Name of persons ing statement
City:
Zip: Phone:
Type of Identification
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
commencing work or recording your Notice of Commencement.
Rev. 8/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
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Rev. 8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/23/2018 Permit Number:
_ J'
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
Address: 1231 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-1418-000-1
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks . Front Back: Right Side: Left Side:
IDETAILED DESCRIPTION OF WORK:
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to be performed under tispermit—check all that appy:
HVAC Gas Tank ❑Gas Piping OGenerator
Shutters Windows/Doors
11 Electric Plumbing Sprinklers E]Roof Q Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 3800.00
5Ft. of First Floor: _
Utilities:n Sewer []Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Claude Masson
Name: Vance R Corbin
Address: 1231 Nettles Blvd
Company: Dodd Enterprises Inc
City. Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No. 514-668-0554
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.