HomeMy WebLinkAboutBuilding Permit Application 0912812018 11:47 (FAX) P.0011003
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,�1�, �/ �7
Date: el i�-. Permit Number: I gl.�'I-C([51 l •
I .
Cot'INT Y —�. .
P L u R 1 D J1 .
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 xx
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION: ,
Address: 2- � S":- ..,..... .1.c. L vt_
Legal Description:
Property Tax ID#: 3:qa'i- I I [- 0 bh - to DLY.. Lot No.
Site Plan Name: Block No.
Project Name: _
Setbacks Front Back: _Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC Change out only York 14seer 3.5ton package unit- 10kw
CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit-check all�apply:
�✓ HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
0 Electric 0 Plumbing ❑Sprinklers ❑Generator 0 Roof- . Roof pitch
Total Sq.Ft of Construction:_ S .Ft.of First Floor: _ .
Cost of Construction:$ 2800 Utilities:lSewer 0Septic Building Height:
OWNER/LESSEE: C AVM VZ., CONTRACTOR:
Name -.‘0�WQ� CC YA-L1 VC. Name: C..0--v•-k.‘.1,-t___
Address: Z -sr-- ' Q _ Company: AC Advantage Inc
r
City: � .1-6- st--- State:FI Address: 1Q 2 L -1 7\ SA-
Zip Code: Fax: City: PSC. .$_ _ State:Fl
Phone No. zip Code: 34984 Fax: 7723367588
E-Mail: Phone No, 7723367366
Fill in fee simple Title Holder on next page(if different E-Mail: csr@acadvantageinc.com
from the Owner listed above) State or County License: CMC1249807 •
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
0912812018 11:47 (FAX) P.002/003
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _-Not Applicable MORTGAGE COMPANY: •• _Not Applicable
Name: - Name: . _
Address; - • Address: • •
City: Stater 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 installatidn 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 thepermitholder to build the subject structure
whit Is in conflict withany applicable Home Owners Association rules,bylaws or andcovenants 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
comme
1 Ing work or recording your Notice of Commencement _
, .4 4,te,--
:nature of Owner/Lessee/Contractor as Agent for 0 ner • ature of Contractor/License Holder •
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L COUNTY OFF!
The forggoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this "Z_ZIL day of �4` ri-- ,20 iS by this 28 day of Rept ,20,$ by ,
CS:4-.-0-x-\N-1,__, Scott Camin co
Name of person making statement Name of person making statement
• rsonally Known - OR Produced identification Personally Known :ex OR Produced Identificatiof #
; ��' a of Identification Type of Identification ..
:educed Produced
.-,,w•-•:.i -..
�, i
* k5 at otary Public- tate of Florida) (Sign- ure of Notary Public-State of Florida) -��';"r '-
7
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` mmission No, 1i�7.d).- (Seal)
r »Commission No. FFT ®z (Seal) •x� t
rm
8
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW _REVIEW
DATE
RECEIVED
DATE - '
COMPLETED
Rev.8/2/17