HomeMy WebLinkAboutBuilding Permit ApplictationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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DESIGNER/ENGINEER:Not
Applicable
MORTGAGE COMPANY:
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Name:
STATE OF FLORIDA
Name:
COUNTY OF Cf
Address:
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City:
State:
City:
State:
Zip: Phone
Type of identification
Zip: Phone:
Produced
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
_4Not Applicable
Name:
(Signature of Notary Public- State of Florida ]
Name:
Commission N . ealj
Address:
h„ Notary Puiilic State of Flarsda
Address:
Suzette Ritchie
City:
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City:
Zip: Phone:
Expires 1211212 21
Zip: Phone:
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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 thepermit 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 Bullding 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.
Rev. 8/2/17
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gnature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF Cf
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this day of 20 by
The forgoing instru nt, as acknowledgefore me
this _ ay of 20 E by
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Name of peZ71naking statement
Name of pars n making statement
Personally Known V OR Produced Identification
Personally Known V OR Produced identification
Type of Identification
Type of identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida ]
Commission No. I)
Commission N . ealj
T7rt,� Natary Public State of Floridan
h„ Notary Puiilic State of Flarsda
a fi uzette Ritchie
Suzette Ritchie
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DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
Address: 1236 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-1423-000-9
Property Tax ID #:
Site Pian Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Change out 2 1/2 ton 14 seer Rheem heat pump split system 5 kw heater like for like
CONSTRUCTION INFORMATION:
Additional work to be oertormed under this Dermit —check all appy:
11HVAC U Gas Tank OGas Piping
11 Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 4500.00
Lot No.
Block No_
_ Shutters Q Windows/Doors
Generator Roof u Roof pitch
5 Ft. of First Floor: _
Utilities:Sewer []Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Marvin Grossman
Name. Vance R Corbin
Company: Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
Address:. 1236 Nettles Blvd
City: Jensen Beach State:Fi
Zip Code: 34957 Fax:
Phone No. 772-229-2329
City: port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
dodd.com
E -Mail: doddenterprises@dodd.com
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: CMC1249958
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.