HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5-31-18
Permit Number:
Building Permit Application
Planning and Developm e-nt Services
8ultding and Code Regulation Division
2300 Viryini . a Avenue,, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax.- (772) 462-1578 Commercial Residential YES
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
,.A
Acld5806 PAPYA DR. FORT PIERCE FL. 34982
ress- .
L-egal Description:
Pro pe rty Tax I D Ly 04;4 0 0
mite Plan Name:
Project Name:
setbacks Front Back: Right Side: Left Side.
DETAILED DESCRIPTION OF WORK:
SYSTEM CHANGE OUT 4TON SAME FOR S/' -'%ME CHANGE OUT 8KW HEAT 14.00 SEER
CONS7RUCTit3N INFORMATION:
-Xd
it'i6hal work to be p rtormed under this permit — c -heck a
HVAC L Gay Tank: [:]Gas Piping
Electric Plumbing Sprinklers
Total Sq. Ft of Con trust
Cost of Construction.- $ 2300.00
owNFRlLEssEE:
I NameKATHLEEN WONNELL
Address, -5806 PAPYA DR.
C
. t"' --ORT PIERCE ity
Zip Code: 34982
1
PNo. 772-335-4955 hone
E-Maik
Fax:
apps :
Shutters
Generator
sc�_ Ft. o I; First Floor:
Utilities:
sewer Septic
State*FL-
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR.0
Name: MICHAEL ROTH
Lot N o.
Block No.
Windows/Doors
Roof Roof pitch
Building Height.-
Company. AM HEATING AND AIR CONDITIONING IN!
Address: 1862 SW. HICKOCK TP.
City: PORT ST. LUCIE
State, F L.
Zip Code.- 34953 Fax:
Phone No. 772-335-4955
E -Mail: JNMHEATINGAC@GMAIL.com
State or County License: CAC1$1919$
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required,
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DESIG-'NERNGINEER` No- Not A��l'icab'te
MORTGAGE COMPANY:
Not Applicable
Name: KATHLEEN WONNELL
Name: MICHAEL ROTH
Ad d cess 5806 PAPYA DR. FORT PI ERCE FL_ 34982
Addre06 PAPYA DR.C
y: FORT PIERCE tate:
City:PORT ST. LUCIEit
State:
Zip: one
11 Zip. Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:1862 SW. HI CKOCK TR.
Address:
City:
City:
Zip** Phone:
Zip. Phone:
OWNER/ CONTRACTOR AF IDVIT: Application is hereby made to obtaina 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 Countymakes no representation that is granting a permit will authorize theermit holder to build the subject structure
which is in contlict with any applicable Home Owners Association rules, bylaws or an 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 financin& consult with lender or an attorney before
0
commencwin ork or
g'4recoruing y our Notice of Commencement.
Signature of Owner/ kp9i7ee'/Contractor as gent for Owner Signature of Contractor/Licen!"older
STATE OF FLORIDA_TATE OF FLORIDA
COUNTY OFLL A -c, t COUNTY OF,
The forgoing instrument was acknowledged before me The fortoing instrument was acknowledged before me
of
day 4,
this 20 4 by this day of .20 by
ca v�.
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
A
(Signature of Notary\Public- State of lorida (Signature of NotaryPublic- State of Florida
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CINDY L ALCHERMES (Se 84'r
Com, I ALCHERMES(Seao
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State of iorir',.',
Commission # FF 240343
10.0 4 Commission # FF 24034%5
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REQ SUPERVISOR PLA Ngr--'� 7, -7 , A�'
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17