HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/11/2018 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
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 2037 Nettles Blvd
Legal Description:
Parcel I D # 4502-501-0040-000-3
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out 2 112 ton 14 seer Payne st cool pkg unit 8 kw heater like for like.
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to e e Orme under this permit —check a appy:
HVAC I Gas Tank []Gas Piping _ Shutters Windows/Doors
Electric El Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: T
Cost of Construction: $ 4000.00
Sq. Ft. of First Floor: _
Utilities: Sewer !_]Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Gary Homan
Address: 2037 Nettles Blvd
Name: Vance R Corbin
Company:- Dodd Enterprises Inc
City: Jensen Beach State: Fl
Zip Code: 34957 Fax:
Phone No. 772-229-7603
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 $2540 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
City:
Zip: Phone
State:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I
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 puilding 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
st...f.[Kllwe.c#*1'1.7t•JSLKS�11rl1l��l•1•JI.01lfRw-1..,tR.lIIIMIL�4IMW..l74.L44
�t (Jll�_ ( -t ca_�
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA. ,, j
COUNTY OF `^!- `Q� COUNTY OF , '4' `^0'
The forgoing instirent was acknowledg efore me
this day of ul� 20 by
Name of person king statement
Personally Known OR Produced Identification
Type of Identification
Produced
��
(Signature of Notary Public- State of Florida)
Commission No.
(votary Public State of Florida
REVIE � 4 'FR€ F €5 'OVWEW.�' 1 II� EVIEW
PERVISOR
RECEIVED
COMPLETED
Rev. 8/2/17
The forgoing instrument w s acknowledged efore me
this kV day of /' � 20 L by
'�../C c^..� Y ( Ut'Z -
Name of person king statement .
Personally Known OR Produced Identification
Type of identification
Produced
a
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Notary Public St
sw4i' T7AcT{, h" R T RILE MANGROVE
=y EW GG 13 ,.RE W REVIEW