HomeMy WebLinkAboutMECHANICAL/HVAC RESIDENTIAL- REPLACEMENT SYSTEM All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: (' "I Permit Number:
RECEIVE®
SEP 2 7 M8
Building Permit Applicatin
Planning and Development Services ST. Lucie County, Permitting
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:
PU6.MRS,I@ IMPROVEMENT LOCATION:
Address: 720/4 PC,,Gi PV_ tqk/e_ � P rce A 3�f�1S7
Legal Description:
Property Tax I D#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DE=NS�R�IPTIO'N OF WORK;
L1'r,0.,4e Perssa^ rr:c rd a�cr_&e -21,?V I I 1727'70
CONSTR I U@ YN INFORMATION:
Additional work to be pertormed under this permit—check all that appy:
vMechanicaI _Gas Tank _Gas Piping _Shutters _Windows/Doors
—Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
cc77 a
Cost of Construction:$ Utilities: —Sewer —Septic Building Height:
OWNER/ NS�S[E- CONTRACTOR:
Name a5l6 ti C, 9C4, ( Tc l/` Name:
Address: 72-69 CLA C-1` I;Ve- Company:
City: Pf 1pi ew e_ State: Address:
Zip Code: 'A41ef ( Fax: City: State:
Phone No. Zip Code: Fax:
E-Mail: ;—fit ('ala A c&tkoa.e-d+"" Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
t J-PPLEMEN L CONSTRlJ Tin LI`�N LAUV NFORMATIO`
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 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
comn_leQcing work or recording our Notice of Commencement.
Si ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder,
.STATE OF,FLORIDA STATE OF FLORIDA
COUNTY OF 5 COUNTY OF
The for oing instr ment was acknowledged before me The forgoing instrument was acknowledged before me
thisP, I day of �-4' 20A by this day of_ 20_ by
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 Identification
Produced Produced '
(Signature of Notary blit-State of Flo_ (Signature of Notary Public-State of Florida)
DEANNA MARIE GIVENS
Commission No. '• '
MYCO(,898$)ON#GG 022023 Commission No. (Seal)
_* *- EXPIRES:December 16,2020
o r Bonded Thru Notary Public Undenrrt tars
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE- MANGROVE
COUNTER REVIEW REVIEW . REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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