HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
STATE OF FLORIDA
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Name:
COUNTY OF ,
Address:
The forgoing instru nt was acknowledge before me
this I day of 201& by
Address:
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State:
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Zip: Phone
Type of Identification
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FEE SIMPLE TITLE HOLDER:NotApplicable
BONDING COMPANY:
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Name:
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Name:
Address:
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OWNER/ CONTRACTOR AFFIDVIT: Appllcation 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 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 fender or an attorney before
commencing work or recording our Notice of Commencement.
Rev. 8/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contracto /License Holder
STATE OF FLORIDA
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STATE OF FLORIDA
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COUNTY OF , IliC _ _
COUNTY OF ,
The forgoing instru ent wa acknowled before me
this day of ; 24 by
The forgoing instru nt was acknowledge before me
this I day of 201& by
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Name of Pers making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
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REVIEWS r
FRONT
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REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/1!2018
COUNTY
F L O R I O_ A_
Permit Number:
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
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 664 Nettles Blvd
Commercial Residential x
Legal Description:
Parcel ID # 4502-501-0850-000-4
Property Tax ID #: Lot No.
Site Pian Name:
Project Name: _
Setbacks Front
Back: Right Side: Left Side:
Block No.
IDETAILED DESCRIPTION OF WORK: I
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw Neater like for like
CONSTRUCTION INFORMATION:
Additional work to be neFformed under t ispermit — check all appy:
®HVAC Gas Tank Gas Piping _ Shutters Windows/Doors
11 Electric Plumbing U Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 3800.00
S Ft. of First 'Floor: _
Utilities Sewer 0 Septic
Building Height:
OW N ERAESSEE:
CONTRACTOR:
Name Patricia Flener
Name: Vance R Corbin
Address: 664 Nettles Blvd
Company: Dodd Enterprises Inc
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No. 772-229-0468
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address: 12.96 SE Industrial Blvd
City: Port St Lucie State: EI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail: doddenterprises@dodd.com
State or County License: CMC1249958
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.