HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO M�JST BE COMPLETED FOR AP.PLICATIONTO BE ACCEPTED
Date; �_ Permit Number;
Building Permit Application
Planning and Development Services
Bullding and Code Regulation Plvlslon
2300 Virginia Avenue,Fart I fierce FL 34982
.Phone: (772)462-1553 Fax; (772) 462.1578 Commercial ' Residential X
PERMITAPPLfCAT10 FOR: Mechanical
Address;
Legal Description: G �� /��� S G /a�S /&N { 5 �yNci S/G t¢
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Property Tax 11)V; I -�6/� 0325 -bad- ( Lot No.
Site Plan Name: !^ Block No.
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Project Name, 3e,
Setbacks Front I_- Back: Right Side; Left Side;
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LIKE FOR LIKE A/C C�IANGEOUT D L4 C% VU 0 r
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Adcutionaf work to bff
armed under t spermit-check all apply:
ZHVAC as Tank []Gas Piping _Shutters ❑Windows/Doors
Electric Q�lumbing OSpriniders Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cast of Construction:$ �.Q� UtilitieSewer F ]Septic Building Height:
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F�Q¢¢ % r' r�S7vor Name; CHRIS LANGEL; /a��f Galin•/of LG s`, Company: SEA COAST A/Cr f rC _ State: f Address: 3108 INDUSTRIAL 31st STREET: �2 dZ Fax: City: FT PIERCE State;FLo, 71? � a /y �/ Zip Code; 34946 Fax; 772-466.3063_ Phone No. 772-466.2400
simple Title Holder on next page ( if different &Mall: INFO@SEACOASTAIR.COM
Owner listed abbvE,j State or County License: CMC035421
If value of construction Is$2100 or more,a RECORDED Notice of Commencement is required.
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S�U!PPLEM NTAL CONSTRUCTION LIEN`LAW IN'FgRMAT'IONi:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not 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: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Countyy makes no representation that Is granting a ermit will authorize the permit holder to build the subject structure
which Is in contlict with any applicable Home Owners Assoc ation rules,bylaws or and covenants that may restrict or prohibit such
structure,Please consult with your Homeowners 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 recordin our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as gent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sr Lucie COUNTY OF sT wc,E
The forgoing Instrument was acknowledged before me The forgoing Instrume/nt was acknowledged before me
this a day of %'G 6 r 20 ?by this day of r 2 Or r U�%,20 t� by
CHRIS LANGEL CHRIS LANGEL
(Name of person acknowledging) (Name of person acknowledging)
2( nature of Notary Public-State of Florida) (s nature of Notary Public-State of Florida)
ersonally Known x OR Produced Identification_ Personally Known x OR Produced Identification
Type of Identification Pro _ — Type of Identification Pr
,,t1lrU6,^ JUSTINALNPPHINS•CONNEILY I Ab-
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JU�'fNA
Commission No. PEsatatt s�; .rs MY December
i1 Commission Na. Fpsnaa ' -• :�: P S•CONN9Lly
II��:�6���pp MycpM� uN
.; 8dodThM`!pecembsr6,2019 u: �i uPFs4f911
ffAt�fbeh Bonded 7hN Nalary Public Urrclerv+dlersus:December s,2019
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
® FORT PIERCE, FL 34982
• 772-462-1553
FAX 772-462-1578
i
AUTHORIZATION FORM FOR CREDIT CARD PAYMENT
TO: St Lucie County
RE:
Permit #
Credit Card Users: 1.5010 Surcharge added per transaction.
Payments must be received in this department by 4:00 PM for transaction to be
processed that day, if hot it will be processed the following business day.
VISA X MASTERCARD
Credit Card Num e �,� L-1 a5a
Expiration Date Zip Code
3 digit security code
_
Amount $ + 1.55% surcharge
Business Name:
Authorized Sig t
Print Name:
Phone: Rk")
Fax:
Comments:
SLCPDSD Revised 4/01/2010 EN