HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y� �"
Date: 10/15/2018 Permit Number: 0 i 0 -0 3
COUNT Y
x L..0R I.. A
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: 125 NE PENLYNN AVENUE
Legal Description: RIVER PARK-UNIT 9-PART C
Property Tax ID#: 3419-570-0112-000-5 Lot No. 14
Site Plan Name: Block No. 81
Project Name: Hollett
Setbacks Front Back: Right Side: Left Side: i.
A/C CHANGE OUT LIKE FOR LIKE 3 TON 16 SEER RUUD S/C SYSTEM
w/ 7. S" 1-4 I-3 Nom;# Si-rip.
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Additional work to be erformed under this permit—check all ;ha apply:
HVAC II Gas Tank nGas Piping ]Shutters Q Windows/Doors
IIIElectric Plumbing L =Sprinklers I I Generator El Roof Roof pitch
I Total Sq. Ft of Construction: S . Ft. of First Floor:n
Cost of Construction:$ 4,000.00 Utilities: _Sewer I I Septic Building Height:
� �� CONACTOR ;rt-0 ,ERf5LE5E` . .
Name JOSEPH HOLLETTName: JASON DIAMOND
Address:125 NE PENLYNN AVENUECompany: DIAMOND A.C. LLC
City: PORT SAINT LUCIEState:FL Address: 1070 GROVE PARK CIRCLE
Zip Code: 34983 Fax: City: BOYNTON BEACH State:FL
Phone No.772-418-5337 Zip Code: 33436 Fax:
E-Mail:JMHOLLETT@AOL.COM Phone No. 561-573-5508
Fill in fee simple Title Holder on next page(if different E-Mail: FIREFIGHTERDIAMOND77@HOTMAIL.COM,
from the Owner listed above) State or County License: CAC1817306
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPL I A► -, ,.,, UC1t i11 ) NL NIA ' :l'
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.
II
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 I
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 be,, .t-...H
commencing work or recording your Notice of Commencement. s r.s"*'--
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Sig ture of Owner/Lessee/Contractor as Agent or-'04nser Sig :ture of Contractor/License Holder '
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a S TE OF FLORIDA - 2��A
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COUNTY OF ♦�I • �LZ> Z � 9 COUNTY OF ` ♦�-Ald .�m '
The forgping instru nt as acknowledged efo z c The for oing instrument was acknowledge fo T z
this / day of ,20 by mT= this j 7 day of ��,� ,20_13k by , a 874-D3
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Name of person making statement 1 a ` Name of person making statement
Personally. -.wn OR Produced Identifi 1... r' Personally Known OR Produced Identification'—
Type of Identifi: o r� Type of I en • 'c tion !i
Produced t._ • V�t(_ Produced
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(Signature of ary Public-State of Florida (Signature of Nota P blic- tate of Florida)y,
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Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT i ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE i
RECEIVED
DATE
COMPLETED
Rev.8/2/17