HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C� Permit Number: / d" d 0 '
Building Permit Application
Planning and:Development Services
Building and Code Regulation.Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:.(7-12)4624553 Fax:(.772)462'1578 Commercial r Residential X
PERMIT APPLICATION FOR: Mechanical
Address: j;z"_ Uj a-
Legal Description: FAIRWAY LANDINGS PARCEL LOT 13(OR 3733-2511)
PropertyTax ID#:3322-500-0017-OQO-5 Lot No.13
j Site Plan Name: Block No..
Project Name:
Setbacks Front. Back: Right Side: Left Side:
D.ET'AILED DESCRIPI-IORI
t
A/C CHANGEOUT, INSTALL RHEEM 3.5 TON, 16 SEER, 10 KW HEATER, S/C SPLIT SYSTEM,
LIKE FOR LIKE
AclO
❑ItIor<to e eunder t Is c ec a _SPP y:
HVAC Gas Tank Ga Piping hutte
rs a Windows/Doors
Electric ❑Plumbing. Sprinklers F Generator F]Roof Roof pitch
Total'Sq.Ft of Construction: S Ft.of First Floor:.
Cost of Construction:$4300.00 Utilities: .Sewer Septic Building Height:
OWN ERCLESSf E CbNTRACTOR x
NameWAHEED ISMAIL Name: KELLY CERTOSIMO
Address:9669;FAIRWOOD COURT Company: AIR TEMP AIR CONDITIONING'
City:'PORT;SAINT LUCIE State:FL Address: 651 NW ENTERPRISE DR,#107
Zip Code: 34986 Fax: City: PORT SAINT LUCIE State:FL
Phone No:303-907-7331 Zip Code: 34986 Fax:
E-Mail: Phone No. 772-3,40-0740
Fill:in fee simple Title Holder on next page(if different E-Mail: AIRTEMPAC@YAHOO.COM
from.the Owner listed above) State or County License: CAC1814837
If value of construction is$2500 or'more,a RECORDED Notice of Commencement is required.
r.•
SUPPLEMENTAL'LCONSTRUCTtON LIEN LAW IN'FORNiATION '`r
^ bx tui t'T '`` x a '4 b c r n +n jl
..:a zn_:. ,F
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name Name:'
Address Address:
,City,. _ Stater City:?, State:
Zip: Phone Zip: Ph"one:.
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:6s,NWENTERPPJsE6R,#107 Address:
City: City
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:ApplicatioMs hereby made to obtain a permitto do the.work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Luc e:County makes no representation that is granting`a permit will authorize the:permit•holderto build the subject structure.
Which is in.conflict With any applicable Home.Owners Association rules,bylaws or andl covenants that may restrict or prohibit such
structure.Please consult with your Home,Otimers Association and reviewyour deed for any resthctio.ns,which may apply.
In`consideration of the granting of this requested permit;I;do hereby agree'that 1 will,in all respects,perform the worn
in;accordance with the approved plans,the Fiorida:Buildir g;C.odes and St Lucie County Amendments.
The following building=permit applications.are exempt from undergoing a full concurrency review room additions,
accessory structures,swimming pooisfences,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 firstinspection. if you intend to obtain financing,consultmilth lender or amattorneybefore
commencin workbr recordin our Notice.of Commencement.
Signature-&t Owner/'&ee/Contractor as Agent forOwner Signature of Contractor/Lic' a Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF CLLCOUNTY OF,-
The for ring instru nt was a cknowledgedoefore me The for oing instru, as acknowledged efore me
thi day of 20 by this day of 20 by
_
U4119 o1( � ,t' c c
Name of 'ersoni making statement �1�4ar�fe o person taking statement
Personally Known)C OR Produced Identification Personally Known_Y OR'Produced.1dentif!cation
Type-of Identificati, n Type of identification
Produced . Produced
c
IAnature Notary Public-:State Sdpn.Lref Notary Public-State of Flo"ri&a
.r. Not4ry Piibiic.$Ot®of to o`�s^'.+i F t'`s�
Catheo it
rine Ronna M han t v NUr,y p,n�to-Stata
Commi ion No. , eal)My<Coc+mtas�on GG?. ommNo_ : er„te utanna Ma
€'19812022 -E - '� y ��mn�+ s GG 17� Y;4�
Z
REVIEWSFRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW' REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2%17