HomeMy WebLinkAboutBuilding Permit Application Nov 13 18 12:36p Louie's Air Conditioning 7724295267 13.1
ALL APPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: . I 1,-1 lJ Permit Number: q k\-OX7q,
COUNTY
F 1. 0 R I gr-A
411.111.111.11.011.1111. Building Permit Application ,
Planning and Development Services
Der
Building and Code Regulation Division
corn
2300 Virginia Avenue,Fort Pierce FL 34982 c ,
Phone:(772)462-1553 Fax:(772)462-1578 ci al esidential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION':
Address: 4S SO-34h 08,-6 4V"31 t ‘4‘'s t 61 5LICI
• Legal Description: „
Property Tax ID#: 3 1/4--V 96 00.03 000 1 Lot No. 1
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILgtv.6ESCRIPTIOWOF:WORk:: ' :' : . :: .-1;1.: ::': I: '' ''' 1.::' : : : ::: • .: • .:.1.' • , ,: ' : . :. ::;
WicsSiCN, )4-trik t -‘ &Or A. 04-8.0-M\ paz_kate._
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CONSTRUCTION INFORMATION
Mdif oril work to bpfiiterformed under tis permit-check all pat apply:
_ VAC
6t
Electric 1 I Gas Tank
[— Plumbing [ Gas Piping
E Sprinklers 1 Shutters
_
Generator 0 Windows/Doors
---1 Roof :
Roof pitch
Total Sq. Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 440lb -- Utilities: Sewer El Septic Building Height: II
II
OWNER/LESSEE:' ': '':- : : ' . : !, : , ii CONTRACTOR:
Name Pr '9_r1-\ 0 ekre f-t_ soc.. Name:
Address: - 62) 4C ItyLs i 19 Company: k.tA.,t.;in`,5 _late___ • •Ic_e_ ‘nc.
City: c)cot- State: PI Address: t A 4-tenl-0-re--- .
Zip Code: akct,s Fax: , PaCity: - State: -Fi
Phone No. q". --* VA2-0, Zip Code: 3-1CtSa Fax:7-iP Lk3lCt-S4z.--4-
E-Nlail: 0 ...1%-r1,a.. ,. e(...41ea,":....0...,,,,., Phone No.4-4- a- las------q0-41 it _
Fill in fee simple Title Holder on next page(if different E-Mail: L01..,,t,t-eS.,.. 01/4 C @ C)•
from the the Owner listed above) State or County License: CAC-0 a. 3I\ II
11 I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
l
Nov 1318 12:37p Louie's Air Conditioning 7724295267 p.2
SUPPLEMENTAL CONSTRUCTION LIED LAW Ii'FOR MATIO11:.- .
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: — Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
1
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.
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
com -ncing we rk or recording your Notice of Commencemen
/
1 / / e ,
1,1.0.-;:y0
ign.ture of Owner/Lessee/Cont ge
/ 34 Owner S' nature of Contractor/License Holder
PORT ST LUCIE,Ft.. 34952-5627
STATE OF FL A 063114030 STATE OF COUNTY OF �/�,�
FOR DEPOSIT ONLY FLORIDA. t , `�;
R4�[-QL?UIE'S AIR CONDITIONING COUNTY OF l.1r�
SERVICE,INC.
The for oing instrum nt was acknowledgf�before me The for ing instru nt as acknowledgedr$efore me
this 14 day of y ov ,2015 by this {Lday of Q V ,20 li E by
Name of e n making statement Name o per n making statement
Personally Known OR Produced identification Personally Known OR Produced Identification
Type of Identificatlbn ,..,....r._._....._.......Type of Identification
,�t.. . AMY K.PEARSON ;'•'•^
Produced Produced •:4 AMY K PEARS �`
eg 4 Commission#FF 235217 ,•� :t. Commission#FF 235217 1
' Expires.May 27,2019 ;+ - Expires May 27,2019
c.......\.. \,(.. ./Z.,,......___I 1st army Frnln,NrraS •,,,w+ 8md�d Ttw 7�vYFanlmuraia BODJ957915
na re of NotaryPublic-State of Florida) (Signa of Notary Public-State of Florida)
Commission No_ �f�o5n 5g1" ' (Seal) Commission No. 3 :2)-- (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17