HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3�_1 , �� Permit Number: vi 43' 43-19?,
RECEIVED
t�'�id161 • .
Building Permit Applicati n MAR 2 7 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 103 LOMAS COURT PORT ST LUCIE FL 34952
Legal Description: RIVER PARK-UNIT 3-BLK 26 LOT 4(MAP 34/22S) (OR 4104-580)
Property Tax ID#: 3419-515-0161-000-2 Lot No.4
Site Plan Name: Block No. 26
Project Name: ERIKA SMITH
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
HVAC CHANGEOUT SAME LOCATION LIKE TO LIKE
RHEEM 3.5 TON RA1642AJ/RH1T4821STAN/10KW HEATER
�e-0 C - V;
=CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit–check all appy:
✓❑—HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
11 Electric ❑Plumbing L__.I Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 5585 Utilities: 0 Sewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ERIKA SMITH Name: STEVEN H MIKLOS
Address: 103 LOMAS COURT Company: MIKLOS AIR INC
City: PORT ST LUCIE State:FL Address: 231 JUPITER STREET
Zip Code: 34952 Fax: City: JUPITER State:FL
Phone No.561-480-5383 Zip Code: 33458 Fax: 561-745-8446
E-Mail: Phone No. 561-575-2173
Fill in fee simple Title Holder on next page(if different E-Mail: STEPHANIE@MIKLOSAIR.COM
from the Owner listed above) State or County License: CAC036799
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
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 a rney before
commenc),ng work or recordjng your Notice of Commencement.
4 /J&J-( — 4 4
Sig ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA " � STATE OF FLORIDA
COUNTY OF �GC r !Yl �� COUNTY OF Aim
The forgoing instrument was acknowledged before me The forgoing instrugient was acknowledged efore me
this day M rC.h .20A by this I day of r 20 b
��4_�n /), y e n H U os
Name of person king statement Name of per so aking statement
Personally Known OR Produced Identification Personally KnownORProduced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of o a �ArAfiFlAMf[i (Signature ofEv*,c*--.,,>*:—vsEt
Notay Public State of Florida tay PublicState of Flonda
Commission No. Stephani le es m Commission N e hanie Barne6Se�l�y Commission GG 197113 y ommission GGG 19 1 3a w Expires 03/30/2022 pires 03/30/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17