HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/3/2018
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O R I D A
Permit Number:
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
Address: 10725 S. Ocean Dr. #194
Legal Description:
parcel ID # 4511-501-0183-000-5
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like.
CONSTRUCTION INFORMATION:
Additional work to be neffio-rmed under this permit — check a appy:
HVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric Plumbing O5prinklers 1:1 Generator F Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 3800.00
S Ft. of First Floor:
Utilities:Sewer 11 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: "
Name Robert Miller
Address: 10725 S. Ocean Dr #194
City: Jensen Beach State: Fl
Zip Code: 34957 Fax:
Phone No. 772-359-6425
Name: Vance R Corbin
Company: Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: doddenterprises@dodd.com
State or County License: CMC1249958
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: J Not Applicable
Name:
BONDING COMPANY: Not Applicable
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
commencing; work or recordiniz vour Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
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SlgTfature of Contractor/License Holder
STATE OF FLORIDA�-
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STATE OF FLORIDA
COUNTY OF. _ _ U' 1
COUNTY OF 14,
The orgoing instr Vent was cknowled before me
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The fpr oin inst mens wa, acknowled efore me
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this day of �1Q.0 WLR, 20 1 by
this day of 20 by
Name of pe rso aking statement
Name of person�naking statement
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Personally Known 1 R Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of identification
Produced
Produced
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act, L
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida }
Commi�ss'ion No. S al)
Commission No. (Seal)
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nny Commission
1 12/202 IRE ie Nyl I I SUPERVISOR
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Kuzette Fti chin
PLAN �T,4 I0"mis I fUP&E MANGROVE
ires 12l
E I REVIEW
REVIE IEi V REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17