HomeMy WebLinkAboutMECHANICAL/HVAC COMMERCIAL - INCLUDES HOODS Sep 2418,02:02p Advantage Air 7724654945 p.2
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BEACCEPTED
Date: �� �ll� Permit Number: Kit, _d S o�
Building Permit Application 1�
Planning and Development Services
Building and Code Regulation Divislon
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-15SB Fax:(772)462-1578 Commercial •— Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine "V Cvz
PP4SED IMPROVEMENT LOCATION:
Address:X15 01-e4 fy_ e- A•e , �, .rye_ cc—, isgg' a
Legal Descrlption:4L 3U aD _23t 4-,,;•j Au AS. &Ia on
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Property Tax ID#a': ocx: l--coo-- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
IEitEQ p.ESCRIPTION OF WORK:
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ONTRUCTfON INFORMATION:
Additional work toe e orme under t -checkspermit a appy:
QHVAC f]Gas Tank Das Piping _Shutters Q Windows/Doors
QElectric Q Plumbing QSprinklers Q Generator Q Roof Roof pitch
Total Sq. Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ ,�,EDQ UtilitiesSewer QSeptic Building Height:
O�NIERAESSEE: CONTRACTOR:
Address:_h/SD Company: u.. 4 -
r
City: 621 State:_IgL, Address:&A S
Zip Code::_2;,cf496L Fax: PIA- City:'r.4 State:TL—
Phone No. 0 14 Zip Code: OMS _
E-Mail: M iA Phone No.77D-gLsS-&Oce
Fill in fee simple Title Holder on next page(if different E-Mail:
from the owner listed above) State or County License ( ic(D[ac(
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Sep 2418,02:02p Advantage Air 7724654945 p.3
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Nbt 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/CON'T'RACTOR 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 ermit holder to build the subject structure
which is in conflict with anV applicable Home Owners Association rules,bylaws or an9covenarits 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 usesto 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
cornmencinR work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF t— � , COUNTY OF —
The for 0'ng inst ent wa acknowledged before me The forgoing inst ent,was acknowledged before me
this day o 20_L-D by this day o 20 by
Gm Lt z. G ,a_ 1F'l�1
Name of person making statement Name of pers aking statement
Personally Known�OR Produced Identification Personally Known X J OR Produced Identification
Type of Identification Type of Identification
Produced Produced
e
nature of Notary Public-State of Florida) ( ignature of Notary Public-State of Florida)
mission No. .`���" — Se M,HILL "..•.•.•...I 0(d3 E)HILL
{ Commission No. o�:: 0
7N#GG 099038 ;F MY COMMISSION#Go 099038
a G; urll 30,2021 3; P� EXPIRES:April 3D,2021
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o VIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
o r COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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i EIVED
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PLETED
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