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HomeMy WebLinkAboutGrinnell County PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 0410912018 Permit Number: IJ.., :.. 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 x PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 7062 Maidstone Drive ,Port Saint Lucie, FL 34986 Legal Description: MAIDSTONE( PB 43-11 ) Lot 101 (OR 4076 - 1629 ) Property Tax ID #: 3322-505-0110-000-2 Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Lot No. 101 Block No. i DETAILED DESCRIPTION OF WORK: - I AC Change Out, Install Rheem 4Ton ,16SEER,1©KW Heater, S/C Split System, LIKE FOR LIKE CONSTRUCTION INFORMATION: CONTRACTOR: NameNora Grinnell Name: KellyCertosimo Additional work toe e orme under this permit —check HVAC Ei Gas Tank F]Gas Piping a appy: In Shutters Windows/Doors 11 Electric F Plumbing Sprinklers MGenerator F] Roof Roof pitch Total Sq. Ft of Construction: State or County License: CAC1814837 S�Ft.{ of First Floor: Cost of Construction: $ 4,800.00 Utilities: LJ Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: NameNora Grinnell Name: KellyCertosimo Address:7062 Maidstone Drive Company: Air Temp Air Conditioning ,Inc. City: Port Saint Lucie State: FL Zip Code: 34986 Fax: Phone No. 239-218-9130 Address: 651 NW Enterprise Drive #107 City: Port Saint Lucie State: FL Zip Code: 34986 Fax: Phone No. 772-340-0740 E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: airtempac@yahoo.com State or County License: CAC1814837 It value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: City: _ State: Zip: Phone: Address: City: — - State: Zip: Phone FEE SIMPLE TITLE HOLDER: i Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: 681 NW Enterprise Drive #107 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 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 Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The f ing instrum nt as ackn wled efore me this day of 2 Vby ti The Ding in Ar n was acknowledged #ore me this day of 20 by n r 15Z'to S t [01. N m pe n making statement Personally Known OR Produced Identification Name f p n ma ing statement Personally K n OR Produced Identification Type of Identification Type of Identification Produced Produced Notary Public State of Florid R' g °F� P°¢� Notary Public State of FlIonda Catherine Donna Mahar e Catherine Donna Mahan • M ommiss+on GG 1768a rely Commission GG 176881 �i g ature of No ry' lc- ��4'I$'`c) {Signature of Notary Ptl �` t fW p- Flori a Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED _�_:_����� Rev. 8/2/17