HomeMy WebLinkAboutDoria County PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/11/2018
Permit Number:
IJ_ II
16
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) 462-3578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 7739 Greenbrier Circle ,Port Saint Lucie ,FL 34986
Legal Description: POD 19 PUD II GREENBRIER (PB41-5) LOT 82 (OR1917-1781;3263-1058)
Property Tax ID #: 3322-700-0087-0000
Lot No. 82
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK:
pit✓ Ch CL.i e CivT Z�S &11 q'7-0,01
/ 5' G1� 6�, i��Gc ✓;
CTION INFORMATION:
C�ffiona
ar tobe e Orme un er t IS permit — C ec
HVAC Gas Tank ❑Gas Piping
a app y:
Shutters Q
Windows/Doors
Electric Plumbing 05prinklers
I Generator Roof
Roof pitch
Total Sq. Ft of Construction:
Sq:. Ft. of First Floor:
Cost of Construction: $ 4,800.00 Utilities:Sewer F—] Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Lorraine Dona
Name: Kelly Certosimo
Address: 7739 Greenbrier Circle
Company: Air Temp Air Conditioning, Inc.
City: Port saint Lucie State:FL
Address: 651 NW Enterprise Drive #107
Zip Code: 34986 Fax:
City: Port Saint Lucie
State: FL
Phone No. 772-429-0363
Zip Code: 34986 Fax:
E-Mail:
Phone No. 772-340-0740
Fill in fee simple Title (Holder on next page ( if different
E-Mail: airtempaca@yahoo.com
from the Owner listed above)
State or County License: CAC1814837
.aWC v. wAix1 UL-LIVII is ;pcauu or more, a KrLUKiJtu r4otice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:_
MORTGAGE COMPANY: _ Not Applicable
Name:.
Address:., -
Address:
City: -_ _ State:
Zip: Phone
City: - State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:----,—. ._._
BONDING COMPANY: Not Applicable
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
commencing work or recording your Notice of Commencement.
i
Signat re of Own r/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA ' ta(�� COUNTY OF
The forgoing instru nt was a cnowledge fore me
this day of 20y
Na a Tf perso m king statement
Personally Known OR Produced Identification
Type of Identificat o
Produced
+e Notary Pulft State of Florida
Cathenne gonna Mahan
're of Notary PuExfi0taffof €t"siri"o/1&2022
Commission No. (Seal)
17 In u J
Signature of Contracto /License Holder
STATE OFF L0 � " �
COUNTY 0F�W_LW_Q 9-
The,#grgoing
this
instrument was am ledged hpfore me
day of n 2CAy
ZONING
SUPERVISOR
Name of pe s n
aking statement
Personally Known
OR Produced Identification
Type of Identification
COUNTER
rte..
Produced
0AM- F W
Nom uI*C
"ufi nd r E a� mm -- -state of
na Mahan Florida
(Signature of Notary Pu
Commission No. (Seal)
OCA I-7tnkg
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17