HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 ,,((��(�
Date: 9-14-2018 Permit Number: 1�oq
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
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Address: 121 SE SERENATA CT
Legal Description: RIVER PARK-UNIT 5 BLK 46 LOT 21 (MAP 34/28N) (OR 3892-66)
Property Tax ID#: 3419-540-0125-000-6 Lot No.21
Site Plan Name: Block No. 46
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETALED DESCRIPTIONMQF b' k; F
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A/C CHANGE OUT OF A 3 TON 7.5 KW 14 SEER YORK UNIT
CONS,TRU ICrN IN'FORMATIO.N ���; r
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Additionalworkto e e orme un er t is permit— ec a apply:
HVAC E Gas Tank Gas Piping _)Shutters Windows Doors
❑ P g ❑Windows/
Doors
❑ Plumbing Sprinklers Generator 1:1 Roof Roof pitch
Total Sq. Ft;of Construction: S . Ft. of First Floor:
Cost of Construction:$ 3090 Utilities. Sewer E]Septic Building Height:
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0111%NER/LESSE - ; ACTORg b#r3 a
CONTR
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Name JEFF GORDON Name: GRETA B SMITH
Address:P O Box 3047 Company: ALL YEAR COOLING AND HEATING
City: Miami Beach State:FL Address: 1345 NE 4TH AVE
Zip Code: 33140 Fax: City: FORT.LAUDERDALE State:FL
Phone No.' ' Zip Code: 33304 Fax:
E-Mail: Phone No. 954-566-4644
Fill in fee simple Title Holder on next page (if different E-Mail: EHARRIS@ALLYEARAC.COM
from the Owner listed above) State or County License: CAC058160
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPEPLEMENTAL C()NSTRIJCTIQN LIEN LAW INFQRM,4TION,
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:
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 . attorney before
commencingwork or recordingour Notice of Commencement.
L 1,14
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gnatur"FLORIDA
essee/Contractor as Agent for Owner Sign ur of Contractor Li ense Ider
AT STAT F FLORIDA
COUNTY OF SAiN LUCIE COU Y OF BRDwARD
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 14 day of SEPTEMBER , 20 18 by this 14 day of SEPTEMBER 20 18 by
JEFF GORDON it GRETA B.SMTH
(Name of person acknowledging) (Name of person acknowledging)
40A_
(Signature of ry P lic- tate of Florida) (Signa o ota y Public-State of Florida)
Personally Known x OR Produced Identification Penown x OR Produced Identification
Type of Identification Produced gfdld if
rsication Produced
e of Flog
Commission'No. (Seal) upGcS Col g3�sion (S
NotaNpNatAs GG il'
�trt0o m�ss9 p22 xo�ty public State of Florida
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Revised 0,7/15/2014 rw �Xplt®e ' �" gXpi050WJ912022
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS