HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
City:
Zip: Phone
State:
Address:
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City: '
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
this day of20
Address:
this __L_ day of 20by
City:
City:
Zip: Phone:
Zip: Phone:
Name of perso aking statement
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 Count 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
commencing work or recording your Notice of Commencement.
Rev. 8/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License 'Holder
STATE OF FLORIDASTATE
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COUNTY OF
COUNTY OF
The forgoing instrument
wa acknowledged before me
The forgoing instrument was acknowledge before me
this day of20
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this __L_ day of 20by
paking statement
Name of person n
Name of perso aking statement
Personally Known
OR Produced identificationPersonally
Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida)
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Commission No.
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REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/1/2018 Permit plumber:
4
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 1330 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-1517-000-5
Property Tax ID #:
Site Pian Name:.
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Change out 2 112 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
Lot No.
Block No.
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name Carolyn Tobin
Address: 1330 Nettles Blvd
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No. 772-229-8613
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Vance R Corbin
AdClitional work to be nertormed under t ispermit- check
HVAC Gas Tank F_] Gas Piping
all
t= appy:
_ Shutters
❑ Windows/Doors
FlElectric Plumbing
Sprinklers
0 Generator
1=J Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 3800.00
Utilities
'n
Sewer
11
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Carolyn Tobin
Address: 1330 Nettles Blvd
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No. 772-229-8613
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Vance R Corbin
Company: Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail: doddenterprises@dodd.com
State or County License: CMC1249958
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.