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HomeMy WebLinkAboutMECHANICAL/HVAC COMMERCIAL - INCLUDES HOODS ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a 1�� Permit Number: .�, � d o1L . RECEIVED Building Permit Applicati®n SEP 24 2018 Planning and Development Services ST. Lucie County~ pprmleeing Building and Code Regulation Division ---— 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line aL PROPOSED IMPROVEMENT LOCATION. Address: ri J ri b S. us Legal Description: Property Tax ID#: �yaa' �5�� dbo1,-a �b Lot No. Site Plan Name: Block No. Project Name: \p\'% Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: L9 V11 � � CONSTRUCTION INFORMATION: Additional work toe nertorme un er t is•permit—check all appy: HVAC 0 Gas Tank Gas Piping _Shutters ❑Windows/Doors FlElectric ❑ Plumbing Sprinklers I Generator E] Roof Roof pitch Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction:$ ;'2 S, 00D. Utilities:n Sewer[]Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name. �oSS� C Name: .; S a Address: 5�4tsc �� ' _j Company:__rr-v,r\2 MQ6�n C?t �Lr C, City: -(0rl-L State: ��:_ AddresD , (Qr-o_,,nC CN0_SS©m Trr l Zip Code: 33 J 4 3 Fax: City.: �����:' State: rL Phone No. -Zip'Code' -.S;1O Fax: E-Mail: Phone No:, +`u0'1 3e1 — -3)(93 L Fill in fee simple Title Holder on next page (if different E-Mail: ed rD SS 0 ,r V;Aep t® C C)'YX from the Owner listed above) State or County License: r7'1G 055 y`7 9 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 Counter makes no representation that is granting a permit will authorize theRermit holder to build the subject structure — -- —%Vh,;ch-:s--ir:-conflict:with-a^y-applicable-Home-Owners-Assflcl3tion-rules,byl3.vs-or-an..covenants-that,i�ay-restrici or piohibit"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 reques ed permit, I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the orida Building Codes and St. Lucie County Amendments. The following building permit application re exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,f nces,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your fa' re to Record a Notice of Commencement may result in your paying twice for improvements to your prope . A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. I y u intend to obtain financing, consult with lender or an attorney before commencingwork or recor i our Notice of Commence ent.` Signature of ner/Less a/Co tractor as Agent for Owner Signature of Contractor/License Holder STA OF FLORIDA STATE OF FLOR,�DI�A� � CO NTY OF COUNTY OF [[�� The fofgg instr en as k owledggsybefore me The forgoing instr ment was acknowledge before me this fnT day of I� 20 by this day of n 20� by V! I 1 Naa of perso making statement Name of per on making statement Personally Known�Wuce OR Produced Identification Personally Known OR Produced Identification of - _—T.-Vi`Fe Gf ider-�tificatio i Produced Pu I' -State of Florid�,��� ��Y LgNC 111111111 F (Signature of Notary Public t t of Florida�Misst � e��o �,��q ON,E�.� Commission No. SHA GaU1St 9 Commission#FF 242406 N• ires06-21-2019 MY Commisslon Exp ••o ; •� Bonded Through Q••d 065230 'qp° �a��• a REVIEWS FRONT ZONII ��: �dF •�/I PLANS VEGETATI TURTLE MANGROVE COUNTER REVIEV_i�AG ••°t�6 Ip`r REVIEW REVIEW REVIEW REVIEW DATE TATE RECEIVED DATE COMPLETED Rev. 8/2/17