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HomeMy WebLinkAboutMECHANICAL/HVAC RESIDENTIAL- REPLACEMENT SYSTEM All APPLICABLE INFO MUST,BE COMPLETED FOR APPLICATION TO BE ACCEPTED �{ Date: �1 Permit Number: ` l cic\ FRECEIVE® Building Permit ApplicationP 2 7 2018Planning and Development Services Building and Code Regulation Division County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 ; Phone: (772)462-1553 Fax: (772)462-1578 Commercial, Residential r' PERMIT APPLICATION FOR: V PR *POSED IIU,PROUEMENT LOCA IQ Address: f 0C� /�► � � r-- Legal Description: 1q(116q5 6bGCg ?9AJJr1LJ5y4-f /-c-'7- Property -c-'Property Tax ID#: 3q/6 -CoOZ_0 e-2 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAIL�DDESCRIPTION OF WORK: C4 NS SITIRUCT10N INFORMATION: Additional work to be pertormed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters. _Windows/Doors, _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ S3o©° 06) Utilities: —Sewer —Septic Building Height: O ER�LE=�S�SE CO TRACTOR: Name4/1'1eS Name: ,TIC. 6A-ieZi Address: 7/00 1_U1z"I�-)F_ City:t'¢ c�7� Lc»� State: - Addre 1725 c3 a Zip Code: Fax: City: y�l� State: Phone No. Zip Code: 35� Fax: E-Mail: Phone No 77Z' �s r 9 l Fill in,fee simple Title Holder on next page(if different E-Mail �/'� ����&-Z e r �® e�o from the Owner listed above) State or County License CpfC If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. ~t1 ' SEMEN L CQNSTFtI.JCTION f.t Rl I.AW � >F� RMATIQ 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 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 covenan s 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 comnleocing work or recording our Notice of Commencement. "VO gnat uFr4 of Owner/Lessee/Contractor as,Agent for.Owner =FLORIDA Contractor/License HolderSTATE OF FLORIDA COUNTY OF Sk_ COUNTY OF 5 k—� Lo i The forgoing instrument was acknowledge before me The for oing instrument was acknowledge before me this�l day of SR-Or 20% by this 0 day of S�� 20-a by �S awe; S S�-l.v1A{ Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identific tion Produced L L Produced (Signature of Notary Publ -State of Florida) (Signature of No �Mp(L1EGN0023 el°"�s '• YCOMMISSIONi�GG022�" Commission No. 5�4�e }j1 N#GG p ommission.No. iRES:Dece , tA1Ss10 20� - N ry}ublic ti. dr:; y GU3p ,M.t cow"'- Bonded ThN • :otr?•• 1�`�5. O'D11C •', -re�.F�,. cam°area."•. • �A1"s-N AC .R. .io5 y�ded z REVIEWS FRONT IRVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER -REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE Kev. 8/2/17