HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/09/2018 Permit Number:
S - ..I J 1 -1 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 x Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 4310 N AIA 802
Legal Description: ALTAMIRA AT NORTH HUTCHINSON ISLAND (OR 1877-769) UNIT 802 SOUTH
Property Tax ID 1i: 1423-565-0038-000-3
Lot
No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side: LeftSide:
DETAILED dESCRIPTION OF WORK:
INSTALLATION OF LIKE FOR LIKE 5 TON CARRIER WATER SOURCE
HEAT PUMP, 13.2 EER
CONSTRUCTION INFORMATION:
Aclartional work to be er 1,111p5l ipr t1 is permit — c ec a appy:
0HVAC
Gas Tank ❑Gas Piping _ Shutters Windows/Doors
11 Electric ❑ Plumbing
0
Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 5,885.00 Utilities:Sewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DOUGLAS CLARKS Name: JAMES F GRIMES
Address: 4310 N AIA 802 Company: GRIMES HEATING AND AIR CONDITIONING
City: FORT PIERCE State: FL Address: 3054 N US HWY 1
Zip Code: 34949 Fax: Cit FORT PIERCE State: FL
y
978-580-7513
Phone No. Zip Code: 34946 Fax: 772-461-8722
E -Mail: Phone No. 772-461-8711
Fill in fee simple Title Holder on next page ( if different E -Mail: KAYLAGRIMESAC@AOL.COM
from the Owner listed above) State or County License: RA0018071
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: �L_ Not Applicable
Name:
Address.
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address.
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.
is inoconflict with any applicable Hothat
e Owners Associe permit will sabylaws or ansermit covenantsthat 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 fnmmanr.---F
ure of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTYOF_ ST • LVCIF
The forgoing instrument was acknowledged before me
this�dayof_ MLI (j �. 20 Aby
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this —9-- day of M 2_tk 20 19 by
c�ff�MAIE—� Pr .7I
(Name of person acknowledging) (Name of person acknowledging)
r
of Notary Public- State of
of Notary Public- State of
Personally Known k1 OR Produced Identification I Personale Known
Type of Identification Produced y OR Produced Identification
Type of Identifica ' n Produced
Commission No.40 111
=. ssion No.
jf•'!u;; SUSAN MONTENEG 0 .;AN MONTENEGRO
MY COMMISSION # GG 0 9099 IISSION # GG 089
Revised 07/15/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
Baled Tluu Notary
ZONING I SUPERVISOR I PLANS I VEGETATION I SEA TURTLE I MANGROVE
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