HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ll /if? Permit Number:
_ _ _
IN Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxx
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 10891 Henerys Road Fort Pierce 34945
Legal Description: fort pierce gardens of 21-35-39 bik a e 87.17 ft of 439.95 ft of n 469.95 It of Ict 2 and lot 3-less e 196.75 ft and less n 36 ft-(2.67 ac) {or 2363-2710
Property Tax ID #: 2321-501-0002-000-4 Lot No
Site Plan Name: Block No.
Project Name: Henry Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
like for like ac system replacement 3.5 ton114.5 seer110kw/vertical
C NSTRUCTION INFORMATION:
Additional work to Elr Orme un er t is permit — c ec a app y:
HVAC u Gas Tank 0Gas Piping Shutters
_ Windows Doors
11 Electric ® Plumbing Sprinklers E Generator 11 Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 7216.00 Utilities: Sewer E Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ralph & Sara Johnson Name: Don Miranda
Address:10891 Henry Road Company: Miranda Plumbing & Air Conditioning
p Y�
City: Fort Pierce State:FL Address: 750 NW Enterprise Drive
Zip Code: 34945 Fax: City: Port St Lucie State: FL
Phone No. 772-332-8680 Zip Code: 34986 Fax: 772-621-2885
E-Mail: Phone No. 772-878-5123
Fill in fee simple Title Holder on next page ( if different E-Mail: LDIODATO@MIRANDACOMPANIES.COM
from the Owner listed above) State or County License: CAC1815486
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and Inszaiiation ds isidluolx1
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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4tJl I II Il I YY U'1� Lf 1 S:LVI U111 Yet.
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DESIGNER/ENGINEER:
Name: _ -
Not Applicable
—
MORTGAGE COMPANY:
Name:
Address:
� Not Applicable
_-
Address:
_ _ _ .. —
City:State:
Zip-, Phone
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
City: _ — r_
Zip: Phone:
BONDING COMPANY:
Name:
State:
Not Applicable
Address: iso Nw ENTERPRISE DRIVE
this JJ day of ~J -+-I 2Q% by
Address:
(J rte' ,_a ►" lf7
City:
Name of person making statement
City:
Zip: Phone:
Personally Known OR Produced Identification
Zip: Phone:
Type of identification
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and Inszaiiation ds isidluolx1
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
.. �1, ^r41nn trnl,r Ki-tir n of rftYY monrPm Pint_
4tJl I II Il I YY U'1� Lf 1 S:LVI U111 Yet.
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r
Signature o'f Owner/ Lessee/Contractor as Agent for Owner
slgnatu e o antractor/License Holder
STATE OF FLORIDA t
STATE OF FLORIDA1-
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrnlment was acknowledge before me
i ���? 20+� by
this JJ day of ~J -+-I 2Q% by
this'—/ day of �4�,
(J rte' ,_a ►" lf7
Name of person making statement
Name of per on making statement
Personally Known _ I OR Produced identification
Personally Known OR Produced Identification
Type of Identification
Type of identification
Produced
Produced
JID_W
�C a-,.-- 2
t'
(Signature of Notary Public- State of Florida j
(Signature of Notary Public- State of Florida }
Commission No = �..",_..Seal}
Commission No.,�`. (Ste" Dlodato
Lori giodato
= Commission # GG069258
r s Commission I GG069258
=* jrgg Feb, 9 2021
REVIEWS
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Fea. V,
ISAMNOWY
PLANS
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VEGETATION ""SE`s TURTLE
thru Aaron Notary
MANGROVE
COUNTED(""'"tEVIEW
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. $ 3� g Lod Diodeta
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CQmmissian # G 6256 0 Commission # GG069258
.. fres Feb. 9, . 202i .1I Furse: Feb. 9, 21121