HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9f25/2018 Permit Number:
s
r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1.553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 1334 Nettles
Legal Description:
Pa rcei I D # 4502-501-1521-000-6
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Change out 4 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
Lot No._
Block No.
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name Betsy Flinn
Name: Vance R Corbin
Company: Dodd Enterprises Inc
Additional work to be nertormed under this ;permit - Check
HVAC Gas Tank E]Gas Piping
III
appy:
_ Shutters
Windows/Doors
11 Electric Plumbing
0Sprinklers
01 Generator
11 Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 4800.00
Utilities:,n
Sewer
F]
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Betsy Flinn
Name: Vance R Corbin
Company: Dodd Enterprises Inc
Address: 1334 Nettles Blvd
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No. 631-258-8186
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 39862344
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: doddenterp(ses@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
MORTGAGE COMPANY:
_7 Not Applicable
Name:
COUNTY OF
Name:
The forg ng instrumen was cknowledged before me
this day of LA - 20 by
Address:
Address:
City:
State:
City: '
State:
Zip: Phone
Type of Identification
Zip: Phone:
Produced
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
' -)blic
(SigRim
Name:
State of PloddaCommission
Comist ie (ealj
Address:
ission GG 135735
117J2021Suzette
Address:
City:
y fires 121121
F
City:
PLANS
Zip: Phone:
SEA TURTLE
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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
commencin,g work or recordiniz your Notice of Commencement.
Rev. 8/2/17
Signature of Ownery Lessee Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA�•���
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrumetwa�acknowledged efore me
this' `day of �`�. *t- - , 20�by
The forg ng instrumen was cknowledged before me
this day of LA - 20 by
Name of pemaking statement
rso
Name of pers making statement
Personally Known OR Produced Identification
Personally Known JZ OR Produced Identification
Type of identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
' -)blic
(SigRim
No. ,,
State of PloddaCommission
Comist ie (ealj
�p�,y Public State of Florida
ission GG 135735
117J2021Suzette
ttChl�
R 5738
°{,'
REVIE'. SC.F
y fires 121121
F
02'1
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
ER
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17