HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: �' ��' Permit Number: r
Building Permit Application RECEIVED
Planning and Development Services SEP 21 !018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Res
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line A I ..-
PROPOSED IMPROVEMENT LOCATION:
Address: 1605 Cody Ln,Fort Pierce,FL 34945
Legal Description: COUNTRY LIVING ESTATES S/D BLK B LOT 11 (1.03 AC)(OR 4021-475)
Property Tax ID#: 2305-500-0023-000-4 Lot No.11
Site Plan Name: Block No. B
Project Name:
Setbacks Front - Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 3.5 ton 14 SEER o /ec.,.., LIce-
CONSTRUCTION INFORMATION:
Additional work tobe nerformed under this permit—check all that appy:
HVAC 0Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 4000.00 Utilities:ll Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Marissa Young Name: Steve Poreba
Address:681 SW Buffum LN Company: Air Xperts
City. Port Saint Lucie •State:FL Address: PO BOX 1168
Zip Code: 34984 Fax: City: Palm City State:FL
Phone No. Zip Code: 34991 Fax:
E-Mail: Phone No, 7727775297
Fill in fee simple Title Holder on next page(if different E-Mail: airxperts@yahoo.com
from the Owner listed above) State or County License: CAC1818229
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name:Marissa Young Name:stove Poreba
Add re ss:1605 Cody Ln.Fort Pierce,FL 34945 Add ress: rmi sw sull-LN
City: Part SwntUrcie State: City: Palm city State:
Zip Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: ,Not Applicable BONDING COMPANY: —Not Applicable
Name: Name:
Address:Po Box„ea 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 regavding your Notice of Commencement.
Signature of Owner essee/Contractor as Agent for Owner Sign ure of Contractor License Holder
STATE OF FLORIDA ASTATE OF FLORIDA
COUNTY OF a Luo Ic. COUNTY OF—
The forgoing instru ent w s acknov l 4 before me The forgoing instrument was acknowledged before me
this lu day of 20 by this 7 day of September 20_ by
Name of person making statement / Name of person making sta ement
Personally Known OR Produced Identification ✓ Personally Known_4::� OR Produced Identification
Type of Identif ion Type of Identification
Produced Produced
A JA4— 64LU
(Signatu of Nota Public-State of Florida) (Signature of N r Public-State of FloridI
Commission No. (Seal)
Commission No Notary Public Stat
na Ackell
5 � My Commission Foe n Explres 05l28f201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17