HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/21/2018 Permit Number:
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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: 1�)Qi 1TcA0M0.Y-mak, 1 �,�� ;err r� �_-L;
Legal Description: Lakewood Park- Unit 1- Blk 1 Lot 16 (Map 13/14N) COR 4072-2793)
Property Tax [D#: 1301-601-0174-000-2
Site Plan Name: Mechanical AC Change out
Project Name: Mechanical AC Change out
Setbacks Front Back:
Flight Side
Left Side:
Lot No. 9
Block No. 16
I DETAILED DESCRIPTION OF WORK: I
Exact Mechanical AC Change out 0\6 Vn1 } ��rl
'i (��x\(SSC 3C1 -�
a
� �i�Z��e� Tt�n ���T�7C•1�1 3TO0
CONSTRUCTION INFORMATION;
Additional work toe performed un er this permit — check a appy:
HVAC Gas Tank FIGas Piping F. Shutters Windows/Doors
CElectric F]Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3,708.94 Utilities: 0Sewer F Septic Building Height.
OWNER/LESSEE:
CONTRACTOR.
Name Christopher Lorentz & Laura Lorentz
Name: Kevin Aguiar
Address: 7301 Palomar St
Company: Nationwide -HVAC
City: Fort Pierce State: FL
Zip Code: 34951-1970 Fax: T
Phone No. 1 (720) 298-4432
Address: 80 8th St, Ste 2000
City: Miami State: FL
Zip Code: 33130 Fax:
Phone No. 877-910-4822 Ext. 704
E -Mail: CHRISLORENTZ@MSN.COM
Fill in fee simple Title Molder on next page ( if different
from the Owner listed above)
E -Mail: hr��nationwide-_)nationwide
State or County License: CAC1818319
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION. 7
DESIGNER/ENGINEER: Not Applicable
Name: Christopher Lorentz & Laura Lorentz
MORTGAGE COMPANY: Not Applicable
Name: Kevin Aguiar
Address: 93oi PgA-PL4M St.
� Address: 7301 P omarst
City: Fort Pierce State-':�f
Zip: -W FSI Phone #7ZO- &!2e- 4/D.2
City: Miami State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: i Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: 80 8th St, Ste 2000
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, 1 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 nonresidential 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 y tend to obtain financing, consult with lender or an attorney before
commencing wR0( or recor our Notice of Commencement. l'I
re of Owner.
as Agent for Owner 1 SihagFuTre of
Holder
STATE OF FLORIDASTATE OF FLORIDA /�
COUNTY OF S'E.yc� { COUNTY OF_ _ .M 1 Cl iiM i - _0Gr/Ye
The ting instrument was acknowledged before me
this day of Am 20 / by
Name ofmaking statement
Personally Knownperso OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- St
C 1127 ( �UKASZ. KOZO
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Commission No,
_ e of Florida-Notar
= a"c Commission # GG 1
MY Commission Ex
REVIEWS I CO N ER REVI W NING S PERVIS
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
The forr�oing instru ent was acknowledged b fore me
this 18 day of , 20 14by
_ lr I61 -i A-0- 10_G -f -
Name of persoryrnak g statement
Personally Known V OR Produced identification
Type of Identification
Produced
re of Notary Public-
State
ion No.0-)61127 20
720
res
LUKASZ KOZ
WY !
tate of Florida-Nbt
y Public
Commission # GG
1 2720
My Commissio
pires
June 07, 210
REPLAV EW NS I VEGETATIREVIEWON S REV EWLE MRE EWVE