HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
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DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
2( Not Applicable
Address:
City:
Zip: Phone
State:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
-kNot Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
Name of perso aking statement
Address:
City:
Personally Known OR Produced Identification
City:
Zip: Phone:
Produced
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain 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.
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 an 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
commencine work or recording vour Notice of Commencement.
Rev. 8/2/17
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA- 0-
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STATE OF FLORIDA �
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COUNTY OF
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The forinstrument was acknowledg before me
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The forgoing instr ent was acknowledged before me
this VS day of l l 20 by
this day o
Name of person aking statement
Name of perso aking statement
Personally Known V OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida j
(Signature of Notary Public- State of Florida
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r Poi Notary Pubilc State 61 Florida $
Commission No. (Seal)
a° Suzette Ritchie
M Commission GG 135736
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DATE
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RECEIVED
DATE
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Rev. 8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/1012019 Permit Number:
.110
C )LINTY
e c o R t n n
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: j772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 894 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-1080-000-2
Property Tax ID #:
Site Plan Name: _
Project Name: _
Setbacks Front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out 2 112 ton 16 seer Rheem st cool split system 8 kw heater like for like.
Lot No.—
Block No.
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name William Weber
Name: Vance R Corbin
Additional work to be ertormed under
t ispermit – check
all
appy:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: doddenterprises@dodd.com
HVAC
Gas Tank
Gas Piping
_
Shutters
Windows/Doors
11 Electric Plumbing
Sprinklers
F l Generator
E]Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 4800.00
Utilities:,n
Sewer
1:1
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William Weber
Name: Vance R Corbin
Address: 894 Nettles Blvd
City: Jensen Beach State: FI
Zip Code: 34987 Fax:
Phone No. 203-948-6450
Company: Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 84952 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 $2500 or more, a RECORDED Notice of Commencement is required.