HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z- -2-0119, 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 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED INPROVEMENT LOCATION:
Address: %-3 ` o_ - �` j'.a) .l
Legal Description: LS.j4Mr< p -r 26A Vt f (IAL;Q
Property Tax ID #: 5 Lot No. 3_
Site Plan Name: Block No.
Project Name: Roqmm=
Setbacks Front Back: RightSide� Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit - check a In
app y:
✓HVAC Gas Tank OGas Piping Shutters Windows/Doors
Electric 0 Plumbing Sprinklers FIGenerator Roof
Total Sq. Ft of Construction: 108;L,
Cost of Construction: $ n
Sq. Ft. of First Floor: _
Utilities: Sewer 11 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR: CENTURY AIR COND
Name 9,OE'ltepti!X kCMttlat i
Name: JOHN RILEY
Address: -:5cghlt4lw Q%C.wWcI,,S 0>
Company: CENTURY AIR COND
Address: 3044 SE DOMINICA TERR
City: State. HIPt
Zip Code: D i0Z[,.Fax: —��
City: STUART State: FL
Phone No. r1$1 - sc�4Q
Zip Code: 34997 Fax:
E -Mail:
Phone No. 772-781-3040
Fill in fee simple Title Holder on next page ( if different
E -Mail: centuryac@aol.com
from the Owner listed above)
State or County License: CAC057676
• ,.1 � 'w".... w', u, 111utC, 4 nrwnutu ivouce oT commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address: _
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City:_
Zip: Phone:
Not Applicable
State:
Not Applicable
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.
otatrepresentation that is granting a
permit
authorize permit the
sodjrstructure is Lucie.
onfliwih any plcable Home Association rules, or and covenants that may restrict opr prohibitsuch
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 Commencement.
re bf Owner/,Agent/ Lessee
ractor/license Holder
ST{AtE OF FLORIDA- S4!E OF FLORIDP�
COUNTY OF ��. �_V QCOUNTY OF�7, t j 6.z
The for oing instr ment was acknowledged before me
this day of 20 by
Zo U Cb l
(Name of person acknowledgi g )
(ignature of Notary Public- State of Florida 1
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
fMA1NN A PAXUll
Pt*k • pith of F
ConatNilIIN I FF 9581
The forgoing instrument was acknowledged before me
this -Cj_ day of 4�QQ%f` 20-Wby
Personally Kn io
T e of Identi a �� ' used SHAWN A
N ry
mission N ' • CommitfIon ! PFF 258939
• y m. ErpM�i Alf/I 11, 2020
' IW410 WArovph N�twW NWtry Assn
Revised 07/15/2014 ••�«i���o'� �0"� NOury Attn �' � � - - - - -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED