HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: !• 0 ' Permit Nu e .
R Em.C,E 1W.,116, Em,D
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Building Permit Applicati n JUL 18 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. L U C i e Co FL
Phone: (772)462-1553 Fax:(772)462-1578 Commercial
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION
Address: 5201 Indian Bend Lane Fort Pierce FI.. 34951
Legal Description: Holiday Pines sid-phase 11-a-lot 192
Property Tax ID#: 1312-800-0023-000-4 Lot No.192
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
change out of air handler and condensing unit 5 ton 16 seer with 10kw heat
CONSTRUCTION INFORMATION:-
Additional work toe nprtormed under tispermit—checka appy:
-ZHVAC Gas Tank E]Gas Piping _Shutters a Windows/Doors
Electric 0 Plumbing ❑Sprinklers ElGenerator E]Roof Roof pitch
Total Sq. Ft of Construction: 2,345 under air Sq.Ft.of First Floor:
Cost of Construction:$ 4550.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name r?n r�1 S A'LejI k f Name: Steven schroeder
Address: 572-01 flan &-nd Lori-e- Company:Air by Steve Ilc
City: 50r - R&Y-ems State: r-L Address: 153 SW South Danville Circle
Zip Code: 3 y 15 I Fax: All A- City: Port Saint Lucie State:FI
Phone No. X702— 3-71�� O 4�1 Zip Code: 34953 Fax:
E-Mail:V enn%S kale( 16L-(6'Ict DO GM Phone No. 7722496812
Fill in fee simple Title Holder on next page(if different E-Mail: airbysteve@gmail.com
from the Owner listed above) State or County License: cac1819127
If value of construction is$2500 or more,a RECORDED Notice of Commencement is'required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: .
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _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 l 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 fist inspection. If you intend to obtain financing,consult with lender or an attorney bef
commenci w k or recordipg your Notic encement.
(Irv" -
Signature of Owner/Lessee/Contractor as Agent owner Signature of Contractor/License Holder g X�
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STATE OF FLORIDA $�o g STATE OF FLORIDA MC Q
COUNTY OF a m a COUNTY OF �o= -_
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The f oing in ru t was acknowledged befo g The forgoing in m t was acknowledged-before a��
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this day o 20,�by rnT 1 this�day of 20 / by
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pile �N V C r D r"t
Name of person making statement Name of person making statement
Personally KmQWn OR Produced Identification Personally Known OR Produced Identification
Type of Identifi ion Type of(dent �icfi fat n
Produced Producedp l ,
.57
A .VJ PJ'_
(Signature of No YPublic-State of Florida 61 (Signofature N 6ryPublic-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
au
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17