HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c'
Date: �-�9 Permit Number: V�d'1051.,,)
V:J , „ �. _ RECEIVED
Building Permit Application APR 19 2018
Planning and Development Services
Building and Code Regulation Division STS Luclo County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial '�C Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: X��� r�
Legal Description: ►' xCc iQ1�C ��S�Q�'1G''1 �.0 1I S 800 ( k i / '301
Property Tax ID#: �'7 — `- — O Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Exec# AC a-)0%?9e CX I t ,31 I z 1 tori- S y s epr iC'CCJH
CONSTRUCTION INFORMATION:
Additional worK to be nertormed under t ispermit—check all appy:
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers ❑Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ LJ�Z' Utilities:Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name L C(n e+ner Name: RICHARD LEVINSON
Address: I vl�5 k�5q)" QJ Company: SERVICE AMERICA
City:V_tS LI�Crl State:�� Address: 2755 NW 63RD CT
Zip Code: 110 Fax: City: FT LAUDERDALE State:FL
Phone No.�)7 Z - Z-,Q—GI��,O Zip Code: 33309 Fax: 954-977-3591'
E-Mail: Phone No. 954-979-1100
Fill in fee simple Title Holder on next page(if different E-Mail: EPERMITSGROUP@SERVICEAMERICA.COM
from the Owner listed above) State or County License: CAC014619
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:
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.
_ s
Signature of Own er/LeskelCdntractor as Agent for Owner Signature o o—fra r/License Holder
STATE OF FLORIQ� STATE OFF OR A i
COUNTY OF 1�('OwO� COUNTY OF ��l
The for oing instru gent w acknowledged fore me The forgoing instrument as acknowledged before me
this day of !'i 20 iYby this day of20 d_by
R�c1-gird L _ ;rlsnn C►wr► LeJl'n 'On
(Name of person acknowledging) (Name of person acknowledging)
/ .
(Signature of Wtvy Public-State of Florida ) (Signature of Public-State of Florida )
Personally Kno n ro ucq I ���pti ication Personally Known duce I en i ica ion
Debbie Jettries T e of Identification r e, Debbie Jeffries
Type of Identif c2 No y Public-Slate rlds yp y vunc-State of Florida
v� Jc CommissioryCp�70668 Commission No. Com #GG 70668
Commission N l ����jj ExP ires2/7/2021
FOF FSO XpreS 1
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS