HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL 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: Not Applicable
Name:
Address:
BONDING COMPANY, Not Applicable
Name:
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.
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
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Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The T
ng inst u nt was acknowledg efore me
thisay of 20 by
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Name of pers making statement
Personally Known OR Produced Identification
Type of Identification
Produced
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(Signature of Notary Public- State of Florida )
Commi
.pP Pl% Notary Public State of Florida
Suzette Ritchie
STATE OF FLORIDA
COUNTY OF
The f Ding instru rent was acknowledg efore me
this day of C D by
Name of prs making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
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REVIE , SUPERVISOR P N%j7 E@ffArl`IV l � ' SEA TURIJE MANGROVE
COUNTER REVIEW REVIEW RE REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/3/2018 Permit Number:
J -
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 I
PROPOSED IMPROVEMENT LOCATION: f
Address: 763 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0949-000-5
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out'3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like.
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit —check all appy:
OHVAC Gas Tank Gas Piping _ Shutters Q Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 3800.00
SFt. of First Floor: _
Utilities:n Sewer ElSeptic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Corinne Doubleday
Name: Vance R Corbin
Address: 763 Nettles Blvd
Company: Dodd Enterprises Inc
City: Jensen Beach State: Fl
Zip Code: 34957 Fax:
Phone No. 631-830-1787
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: Fl
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
Fill in fee simple Title Holder on next page [ if different
from the Owner listed above]
E -Mail: doddenterpdses@dodd.com
State or County License: CMC1249958
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required,