HomeMy WebLinkAboutBuilding Permit Applicaiton All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G Ctn.— (J y� )3-
Date: l I Permit Number:
Mrt RECEIVED
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3 T'- , FEB 0 B mg
iiiiE:a._.. i:_` E .' Building Permit p ica ip.,>1
Planning and Development Services L110,6,„, ;
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE: EXACT AC CHANGE OUT
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Address: 171 N CAPRONA AVE
Property Tax ID#: 3419-530-0231-000-1 Lot No.
Site Plan Name: Block No. 4109/1721
Project Name:
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Additional work to be performed under this permit—check all that apply:
e'Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers —Generator _Roof Pitch
—Total Sq. Ft of Constructio : 1) Sq. Ft.of First Floor:
Cost of Construction:$ VOD V / Utilities: _Sewer _Septic Building Height:f
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Name warbird Properties Ile Name: SANTIAGO BOLIVAR
Address: 4010 S 57TH AVE STE# 103 Company:ACTION MECHAN AL CO TRACTORS
City: GREENACRES State: Address:6358 WESTOVER RD
Zip Code: 33463 i Fax: City: WEST PALM BEACH FL, State: FL
Phone No.603-755-1059 I Zip Code: 33417 Fax:
E-Mail: Phone No561-642-4730
Fill in fee simple Title Holder on next page( if different E-Mailluisverasamc@aol.com
from the Owner listed above) State or County Licensecmo-056748
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: I
Address: Address:
City: I State: City: State:
Zip: Phone_ Zip: _ Phone:
I
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address: 1
City: City: I
Zip: Phone: Zip: Phone: 1
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. I
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 our paying twice for
improv ments to your property. A Notice of Commencement must be recorded a i osted on the jobsite
befor :rte first inspection. If you intend to obtain financing, consult with lender On attorney before
corn e'-cing wor r recording your Notice of Commencement. /
Signature of Owner/Lessee/Contractor as Agent for OwnerSigna re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF FL COUNTY OF PALM BEACH
The f.,going instrumW as acknowledged before me The forgoing instru nt was acknowledgeSjbefore me
this i0 day of �'thnn_- ,20 fl by this , day of ,20 1 I by
Name of person making statement. Name of person making statement.
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Prod ced
h
(Signa re of Notar VMS
(Signature of Notary P .1 � of FloricW)S R VERAS
GG `Isom;
ass�� MY COMMIN#CO�73E4c;4 ,; _ MY COMMISSION#GG 035494
Commission No. ���� Commission No. GG 035: ;�;: EXPII g I
xPIR r 3.'L07.0 ;F;off: ober 3,2020
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.9/26/18