HomeMy WebLinkAboutBuilding Permit Application 05/21/2018 10:21 (FAX) P.0021004
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 a Permit Number: 1�Os�dS�Oy
Building Permit Application
Planning and Development Services
Bullding and Code Regulation Dlvlslon
2300 Vlrg/nla Avenue,Fort Plerce FL 34982
Phone: (772)452-1553 Fax:(772)462-iS78 Commercial Residential:xx
PERMIT APPLICATION FOR: Mechanical
Address: 6524 Yedra Ave
Legal Description:
Property Tax ID 4: 1305 111 0001'0000 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC change out only Trane 4ton 14seer Pkg Unit 10kw
i ions war o e er orme un er is perms –c ec a appy:
✓HVAC Gas Tank OGas Piping —Shutters O Windows/Doors
OElectric Plumbing OSprinklers O Generator O Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:5 4674 Utilities: Sewer OSeptic Building Height:
U1NiVEI GSE . CbNTRAc-roR
Name Johanne Trembley Name: ScottCamlrO
Address:6524 Yedra Ave Company: AC Advantage Inc
City: Fort PlerceState:F� Address: 1925 SW Biltmore St
Zip Code: 34851 Fax: City: PSLucle State:Fl
Phone No. Zip Code: 34984 Fax: 772-336-7566
E-Mail: Phone No. 772-336-7366
Fill In fee simple Title Holder on next page(if different E-Mail: csr@acadvantageinc.com
from the Owner listed above) State or County License: CMC1249807
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
05121/2018 10:21 i:AX) P.0031004
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Joh-ne'rremblay Name:scottcamlre
Address:w24YedraAV* Address:. E524Yedrams
City: Fon Pierce• State: % City: PSLUcIe State:
Zip: Phone zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:i926eweutmoraet Addres_'s:
CI'ty: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permlt 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 L cie County makes no represerl tion that is granting a permit will authorize the permit holder to build the subject structure
Ach is In conflict with any appllcab a Home Owners Assoclatlon 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 wlth the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permlt 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, consu#with lender or an attorney before
comme*ing work or recording our Notice of Commencement. tlr
1
S nature of Owner/Lessee/Contractor as Agent for Owner Sig ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
CO U NTY 0 F st Lucie CO U NTY OF ar wra.
The forgoing Instrument was acknowledged before me The forgoing Instrument was acknowledged before me
this 21 day of -Y 2UT by this 2 day of mw 20,E by
Name of person making statement Name of person making statement
Personally Known xxx OR Produced Identification Personally Known xxx OR Produced identification
Type of Identification Type of Identification
Produced Produced
Signa ure of Notry Public-State of Florida j (Sig ture o Notary Publfc-S ate of Florld� le Peine
Jamie Peine
FF raaaaWARY PUBLIC FF1722e2 f>~Q RY PUBW
Commission No. STATE OF FLORIDA Commission No. 1iYAp"t OF FLORIDA
. Camn#FF17Z202 Comrr*FF172202
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17