HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �-1
Date: �' �Q •1 Permit Number: ) y oZ o 4 a.
Building Permit Application
Planning and Development Services FE'S 16 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRQPOSED IMPROVEMENT LOCATION`
Address: 202 se selva ct
Legal Description: river park unit 6
Property Tax ID#: 3419-545-0101-000-7 Lot No.4
Site Plan Name: Block No. 62
Project Name:
Setbacks Front Back: Right Side: Left Side:
D.ET�ILED DES:CRIPTION:OF WORK: .. Ai
like for like air conditioiner change out 2 ton 14 seer 5'kw heater
CON.STRUCTIO:N INFORMATION
Additional work to be nertormed under this permit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3498.00 Utilities: Sewer Septic Building Height:
OWNERAESSEE. :` ,CONTRACTOR:"
Namelohn grossman Name: christopheriarrach
Address:440 colonial dr Company: american air cares inc
City: beaver creek State:oh Address: 545 nw mercantile place
Zip Code: 45434 Fax: City: port st lucie State:fl
Phone No.772-579-9944 Zip Code: 34986 Fax:
E-Mail: Phone No. 772-398-0023
Fill in fee simple Title Holder on next page(if different E-Mail: chris@americanaircares.com
from the Owner listed above) State or County License: CAC057481
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONST
RUCTION,LIEN'LAW INFORMATION
f
b iL
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:phn g—man Name:christopher;arrach
Address:=se-l-ct Address: 44o colonial dr
City: beamcreek State: City: port stlucie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:Sas m mercantile place 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 thepermit 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 1 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
WAR ING TO OWNER:Your failure to Record a Notice of Commencem t may result in your paying twice for
imp eme s to your property.A Notice of Commencement mus recorded and posted on
befo e h st inspection. If you intend t nancing, cos ith lender or an attorney fo�,e
co m n work or recordingour Noti o C mence a >' o
p,
i tiJ�N $ =Z��'
Signatur f Owner/Lessee/Contractor as Agen r Signtc,
f Contractor/License Holder ww zit
STATE OF FLORIDA ? STA FLORIDA ¢�w o
COUNTY OF 8X~ COUNTY OF044dx
S
The forgoing instrume t w s acknowledge efo Mel..;o The forgoing instrum was acknowledged befo
this_( day of 20 by this day of 20�by #..
„fi.,•
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identificati
Type of Idenx' ' ' Type of Identification
Produced on Produced
114 a444�
(Signature of No&Y
Public-State of Florida U (Signature of Nol(!
Public-State of Florida)
Commission No. (Seal) Commission No. (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