HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 914!2018 Permit Number:
1'
BUilding Permlft AppI!LdL!Vn
Planning and Develavment Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 535 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0721-000-1
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
Commercial Residential X
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:
CONTRACTOR:
Name Wilma Klein
'Name: Vance R Corbin
Company: Dodd Enterprises Inc
Additional work to florme un er t is permit — e ec
HVAC Gas Tanis E]Gas Piping
a
appy:
_ Shutters
Windows/Doors
Electric ❑ Plumbing
1:1Sprinklers
01 Generator
1:1 Roof Roof pitch
Total Sq. Ft of Construction:
S . Ft. of First Floor:
Cost of Construction: $ 3800.00
Utilities Cn
Sewer
E]
Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Wilma Klein
'Name: Vance R Corbin
Company: Dodd Enterprises Inc
Address: 535 Nettles Blvd
City. Jensen Beach State: Fl
Zip Code: 34957 Fax:
Phone No. 786-351-3149
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: PI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
E -Mail: doddenterp(ises@dodd.com
State or County License: CMC1249958
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: XNot Applicable
Name:
Add ress:
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 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 vour Notice of Commencement.
rk
Signature of Owner/lessee/Contractor as Agent for Owner
Signature of contractor/License Holder
STATE OF FLORIDA/� w. ,`
COUNTY
STATE OF FLORIDA
OF_OT a
COUNTY OF
The f rgoing instr e wa acknowledg fore me
The fo going instr en was knowledg d efore me
this day of 20 by
this day of �6v 20 by
Name of pegs making statement
Name of pees making statement
:
Personally Known OR Produced Identification
Personally Known 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 No, (Seal)
Or P44Notary:unbi'lc State of Florida
Ritchie
Suze
issicn GG y35736
Y N% Notary Public State of Florida
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SUPERVISOR
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PLAN P{{ 2/1SRA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIE °� Vy
4
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17