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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 5— , Permit Number: RECEIVED Building Permit Applications �,i-AY 2 2 � Planning and Development Services i . Lucie County, Permitting 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: To Select from dropbox, click arrow at the end of line Ud`L PROPOSED IMPROVEMENT LOCATION: Address: 4844 Watersong Way Fort Pierce, FL 34949 Legal Description: Watersong PUD PLAT NO.1 (PB42-34) LOT 42 Property Tax ID#: 2532-500-0056-000-2 Lot No. 42 Site Plan Name: Block No. Project Name: Ezer Tossas A/C Change out Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Exact change out of 4.0 Ton system CONSTRUCTION INFORMATION: Additional work to be performed under this permit–check all that appy: ©HVAC Gas Tank ❑Gas Piping 11 Shutters Windows/Doors ❑Electric ❑ Plumbing 11 Sprinklers FIGenerator ❑ Roof Roof pitch Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction: $ 10309.25 Utilities:]Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Ezer Tossas Name: Theodore Morgan Address: 4844 Watersong Way Company: Premier Comfort Services, Inc. City: Ft Pierce State: FL Address: 2711 Vista Parkway Suite B-14 Zip Code: 34949 Fax: City: West Palm Beach State: FL Phone No. 917-856-3385 Zip Code: 33411 Fax: E-Mail: Phone No. 561-444-3670 Fill in fee simple Title Holder on next page ( if different E-Mail: theom(lpremiercomfortac.com from the Owner listed above) State or County License: CAC 1816827 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: �I Not Applicable MORTGAGE COMPANY: Not Applicable Name: T Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: 4- 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 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. L L Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Palm Beach COUNTY OF Palm Beach The for ing instrumenxw s acknowledged before me The foicrig instrume t�yv acknowledged before me this JYday of f� 20 18 by thisay of �l 2018 by Theodore Morgan Theodore Morgan Name of person making statement Name of person making statement Personally Known X OR Produced Identification Personally Known X OR Produced Identification Type of Identification Type of Identification Produced Produced (Sig to a of Notary Pu li -Satqf Florida ) (Sigffature of eLuaj - I i 1> •. SOPHIA LEWIS . �$Q Pj� LEWIS A-7-1 . Notary Public-Stateo Commission No. _°• ,; Notary lP?iSt �StateofFlorida Commission N Y (�ab) s; ommission#GG 189337 Commission#GG 189337 OFc�6My Comm.Expires Apr 24,2022 My Comm.Expires Apr 24,2022 Bonded through N Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17