HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Developmenf9ervices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION
Address: 1305 WHITE OAK LANE
Legal Description: SILVER OAKS ESTATES LOT 9
Property Tax ID #: 3409-803-0008-000-5
Lot No.9
Site Plan Name: CAMPOLA
Project Name: MARGUERITE CAMPOLA Block No.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CHANGE OUT OF 4T STRAIGHT COOL 16 SEER SPLIT SYSTEM
WITH 10 KW HEAT
CONSTRUCTION INFORMATION:
MUUhI���Itllmna wor to a erorme un ert is permit —c ec a appy:
.Gas
IIL� ,IIHVAC Tank []Gass Piping _Shutters Windows/Doors
OElectric OPlumbing
Sprinklers ®Generator Roof Roof pitch
Total Sq. Ft of Construction: 1696 5 Ft. of First Floor:
Cost of Construction: $ 4365.00 Utilities: Sewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameMARGUERITE CAMPOLA Name: DAVID BINDER
Address: 1305 WHITE OAK LANE Company: SPEEDY AC SERVICE
City. FORT PIERCE State:FL Address: 532 NW MERCANTILE PLACE #111
Zip Code: 3498? Fax: City: PORT SAINT LUCIE FL
State:_
Phone No.-77 a $6 I Ot g b 34988
Zip Code: Fax: 772'9343511
E-Mail:
Phone No. 772-871-1560
Fill in fee simple Title Holder on next page ( if different E-Mail: INFO@SPEEDYACSERVICE.COM
from the Owner listed above) State or County License: CAC1817623
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable
Name:
MORTGAGE COMPANY:
Not Applicable
Address:
Name:
City:
Address:
State:_
Zip: Phone
City:
State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
_Not Applicable
Name:
Address:
Address:
City:
City:
ZIP: Phone:
Zip: Phone:
DWNER/ [DNTRerTnR eeumm..__,. _..
--".. . •--• • • ^r•rw.,�„.a noeuy mane to cousin a permit to do the work and Installation as indicated.
certify that no work or installation has commenced prior to the Issuance of a permit.
it.
iLucie
ICount makes no representation that is granting apermit will authorize the permit holder o h�," en o.�,l.�e...,........_
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work r
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 ncn-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
beeforne her first inspection. Iff you Intend to obtain financing, Cos) It with lender or an attorney before
com
�•ao,,.�=..,....noir cesseers,omraaoras Agent for Owner SlgnaturNof Contractor/License Holder
STATE OF
COUNTY OFORIDA Do(+ 1• �C f� OUSTATNTYOFORIDA Porgy-
The forgoing instrument was acknowledged before me
this J_L day of 20-n by
lowls &V)Ct -e_e
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
,ISignature of teary Public -State of Florida I
The forgoing lnstrume t was acknowledged before me
this LLdayof JA.Y 20M by
106V id 81r
Name of person making statement
Personally Known _) OR Produced Identification
Type of Identification
Produced
Notary
COUNTER I REVIEW I SREVIEW R I REVIEW REVIEWONy S EVEWLE I MEVIERWOVE