HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone
Not Applicable
State:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTY OF
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
-) Not Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
Personally Known OR Produced Identification
Address:
Type of Identification
City:
Produced
City:
Zip: Phone:
(Signature of Notary Public- State of Florida }
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 your Notice of Commencement.
Rev. $/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDASTATE
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OF FLORIDA <4
COUNTY OF d "`Lo_
COUNTY OF
The for oing instru e(� was acknowledg fore me
this day of �f 2q y
The for ping instrum n was acknowledged efore me
this l day of �o by
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Name of perspn making statement
Name of perso aking statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of Notary Public- State of Florida }
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REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. $/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/12/2018 Permit Number:
•
Building Permit Application
Planning and Development Services
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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 231 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0417-000-7
Property Tax ID #:
Site Plan Name:
Project Name: ____
Setbacks Front
Back: Right Side: Left Side:
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
Lot No._
Block No.
CONSTRUCTION INFORMATION:
Additional work to be erformed under tis permit check all appy:
HVAC Gas Tank 0Gas Piping_ Shutters a Windows/Doors
Electric LJ Plumbing Sprinklers El Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 3800.00
Sq. Ft. of First Floor: _
Utilities Sewer n Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
!Name Lester Doll
Name: Vance R Corbin
Address: 231 Nettles Blvd
Company: Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
City: Port St Lucie State: FI
Phone No. 732-616-6588
Zip Code: 34952 Fax: 335-3310
E -Mail:
Phone No. 398-2344
E -Mail: doddenterprises@dodd.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CMC1249958
ii value or construction is ry1zouu or more, a KtLUKutu Notice of Commencement is required.