HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE 1NF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ' 1
Date: Permit Number: I`
�r
RECEIVED
Building Permit Application MAY 0 4 2018
Planning and Development Services
Building and Code Regulation Division ST, Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34981
Phone:(772)462-lS59 Fax:(772)462-2578 Commercial x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the and of line V
Address: �y_ �� �Cf'Ct,nQny�_ �n;ys�► y � ,
Legal Description: REGENCY ISLAND DUNES TWO
Property Tax ID#: 3534-502-0000-000.0 Lot No
Site Plan Name: Block No.
Project Name: REGENCY ISLAND DUNES NORTH BUILDING
Setbacks Front Back: Right Side: Left Side:
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REPLACING 2 EXISTING COMMERICIAL AMERICAN STANDARD 12.5 TON PACKAGE AC
SYSTEM NO SEER 15 HEAT KW. UNITS LOCATED ON SOUTH AND NORTH TOWER OF THE
NORTH BUILDING.
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Additional work to orme under this permit—c ec a appy:
HVAC 11Gas Tank []Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing OSprinklers E]Generator Q Roof Roof pitch
Total Sq, Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 57,440.00 UtilitiestSewer OSeptic Building Height:
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Name Name: -+
Address:�rr<T , �)f_PC%y� �YS�le _ Company: TREASURE COAST AIR CONDITIONING,INC.
City:_ _�,,o� lLl/� 5tate:F� Address: S p 1 > 1 -
Zip Code: alt Fax: City: plan CON, _ _ _- State:FL
Phone No.772-229-0311 Zip Code: 34890 Fax: 772-288-7046
E-Mail: Phone No. 772-692-1701
Fill In fee simple Title Holder on next page(if different E-Mail: TCAC1990@ATT.NET
from the Owner listed above) State or County License: CAC056476
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
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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:
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 make 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,1 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.
Signoture of er/Lessee/Contractor as Agent for Owner S ature of C tractor/License Holder
-- u re o_
STATE OF FLORIDA STATE OF FLORIDA e ��Jw
��"�COUNTY OF CiCOUNTY OF
The f rgping Instrumen was acknowledge efore me The f rg Ing instru e t was acknowledg d before me
this r ay of 20 by this Aay of 201L by
LUklq 14. X Q• qj-
Name of person making statement Name of pers n making statement
Personally Known OR Produced Identification Personally Known V� OR Produced Identification
Type of Identification Type of Identification
duced Pr ced
(Signature of-Notary Public-St t (Signature of Notary Public-State of Florida)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE _
COMPLETED
Rev.8/2/17