HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE.ACCEPTED
Date: �T9-
Permit Number:
RECEIVED
Building Permit Application JAN 2 2 r
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, PernAtifig
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: 5509'Pinetree Drive, Ft. Pierce, FL 34982
Legal Description: Indian River Estates
Property Tax ID#: 3402-602-0256-000-0 Lot No.39 and 40
Site Plan Name: Block No. 7
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out like for like 3 1/2 ton', 16 SEER, 8KW heat, Carrier condenser 24APB642A003, air handler
F134CNP0421_00
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all that appy:
HVAC Gas Tank �Gas'Piping _Shutters Q Windows/Doors
Electric 0 Plumbing E]Sprinklers ElGenerator F] Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ $4100.00 UtilitiesIn Sewer Septic Building Height:
NW Ira 4pmm
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+^"" .FL us'� r ° 690 S11V Qyeblo�Terrace
State._ Address: __
Zip Code: 34982 Fax:n/a City: Port St Lucie State:FL
Phone No.712-672-9220. Zip Code: 34953 Fax: n/a
E-Mail:b/a Phone No. 772-519-1351
Fill in fee simple Title Holder on next page(if different E-Mail: ackeithl@at4.net
from the Owner listed above) State or County License: CAC1813976
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LEEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: N'ot'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:690 sw Pueblo Terrace 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
comrnpriging work or re_cording your-Notice.of Commencem
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Signature of Owne /Lesse0fontractor as Agent for Owner Signature of Contractor/ icens older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S? [—%-j c_X 42_� COUNTY OF S� t_y UkC—
The forgoing instrument was acknowledged before me The forgc1ing instrument was acknowledged before me
thisr l day of 1gv ao.- 20 I'f by th1isQUday of 20A by
��i Corse iI I�7owln(o�, I(�P 11 f_� 60/v►eX.f. %.cnwrosot�
Name of person making statement Name of person making statement
Personally Known OR Produced Identification)! Personally Known OR Produced Identification_
Type of Identification. Type of Identification
Produced F L D(_ Produced
(Signature of Notary u aSl nature of Notary Pu at
Commission No. �4 r� F'` TnEODOR SARANT g _ ;o "6�''y THEODORE 6 R TOS,
Y - ,_1 Iii Public•Stats of Flo 'a mission No.G(r AKN�� 3 =r• t�ptary p wlb, S at flgtl�li
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Commission N Gti Cortinr�clon N Tt3�
°� My Comm.Expires Nov 3 '••.';�oFr:���.f•' fi?Comthxpfre v,31 2026
REVIEWS FRONT ZONING SUPERVISOR P ANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW' REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 3
RECEIVED
DATE
COMPLETED
Rev.8/2/17