HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��0 Permit Numbn.
REC IVE
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Building Permit Application APR 1.0 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
3
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PROPOSED IWROVEMENT LOCATION
Address: 6810 US HWY 1 PORT ST LUCIE FL 34952
Legal Description: SEE ATTACHED
Property Tax ID#. 341580000010006 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
£
DE,TAI(ED DESCRIPTIONrOF WORK
CHANGE OUT CARRIER TON RTU PACKAGE UNIT ZONE #5
CONSTRUCTION INFORMATION
Additional work toa nertormed under this permit-check all appy:
RIHVAC Gas Tank []Gas Piping _ShuttersaYRoof
indows/Doors
11Electric ❑ Plumbing Sprinklers Generator Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ Q� ®?® � Utilities:Sewer Septic Building Height:
Q, _N a„ CONTRACTOR
ER/LE
Name �n Qom( �--�- Name:
Address: PO Company: COMFORT CONTROL OF SLC
City: MCAS. CNN State:FL Address: I so (+fV14Y're_
Zip Code: 32341 Fax: City: PSIL State:FL
Phone No.321-302-6099 Zip Code: 34983 Fax: 772-785-9144
E-Mail:Ruthinc85@embargmail.com Phone No. 772-785-9010
Fill in fee simple Title Holder on next page(if different E-Mail: COMFORTCONTROL34983@GMAIL.COM
from the Owner listed above) State or County License:_ CACO24379
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER. X Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address:6810 US HWY 1 PORT ST LUCIE FL 34952 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 attorney before
commerAling work or recording our Notice of Commencement.
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igna re er/Les ee/Contractor as Agent fo •; pg Sign ure4coat /License Holder
STATE O FLORt o Mr i STA A
COUNTY OF COUNTY OF I+ .UP-0-uQ
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The for oing instruqlent was acknowledge efore Kms'm The forgoing instrument was acknowledged before me
this 1 day of 20,Ltby �g this�day of 'Apr-'l 20 )B by
L � ► rY7 �2.-1'Y� A� 1�ar-n.� �N�v��e..��r�n
Name f perso aking statement a Name of person making statement
Personally Known OR Produced Identifica Personally Known X rC i
Type of Identification Type of Identification F?'W'k
Pya Notary Public State of Florida
Produced Produced '� Tracey Mascola
c My Commission FF 971067
or Expires 04/26/2020
(Signature 01
otary Public-State of Flor ) Signature of eary Public-State of Florida)
Commission No. (Seal) Commission No. ^C vM.- (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17