HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
Not Applicable
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_XNot Applicable
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 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
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Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA f r
COUNTY OF
The forgoing instrument was acknowledged efore me
this Iayof L' 20 by
0 1- ' i -
Name of persot'making statement
Personally Known l,J OR Produced Identification
Type of Identification
Produced
(Signature of Notary k i -
�SoWry Public State of Fionaa
Comm i i a, z�,+o a,�rrie C
S 1y Commission GG 135736
Expires 1211212021
REVIEWS FRONT ZONING
COUNTER REVIEW
RECEIVES}
DATE
COMPLETED
Rev. 8/2/17
STATE OF FLORIDA
COUNTY OF
The forgoing instr ent was acknowledge efore me
this day of��l t1 rL,1 20 by
1
Name of perso aking statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
�tls Nc,tary :'ub±ic State of Florida
J�"�� my Commission GG 135738
SUPERVISOR PLANS �Vk&l�iAi W1226VA TURTLE w MANGROVE
REVIEW REVIE1r1V" ,`RFA4EV%(,,; �. REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/25/2018 Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 452-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 1327 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-1514-000-4
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
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 appy:
OHVAC Gas Tank E]Gas Piping _ Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 3800.00
S Ft. of First Floor: _
Utilities Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Michael Fowler
Name: Vance R Corbin
Company: 'Dodd Enterprises Inc
Address: 1327 Nettles Blvd
City: Jensen Beach state: Fl
Address: 1296 SE Industrial Blvd
Zip Code: 34957 Fax:
City: Port St Lucie State: FI
Phone No. 570-687-3319
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
Fill in fee simple Title Holder on next page ( if different
E -Mail: doddenterprises@dodd.com
from the Owner listed) above)
State or County License: CMC1249958
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.