HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTY OF _ 41_Q_J
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_XNot Applicable
Address:
Name of person making st Cement.
Address:
Personally Known OR Produced Identification
City:
Type of Identification
City:
Produced
Zip: Phone:
Zip: phone:
(Signature of Notary Public- State of Florida) —__
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 thepermit 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 v4ith 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Rev. 2/7/19
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA'
COUNTY OF
COUNTY OF _ 41_Q_J
The for ing instru t was c knowledge before me
day �j
The fo4ring instrume t was acl nowledged before me
this of 20 by
this'day of 2013 by
Name of person making st Cement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known I_/'�•✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida) —__
(Signature of Notary Public- State of Florida )
Commission No.
Commission No. (Seal)
r Notary pub!'sc State of Florida
TA
uZ
REVI L G� 2sslo GG 135
°CONI SUPERVISOR
Or"
u c State of Florida
Suzette Rr c
PLAN �� TXPO M111 i%�GLE MANGROVE
I REVIEW
REVIE IE�fP'rp$ 12/ 2/2V REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/18/2019 Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 712 Nettles Blvd
Property Tax ID #l:
Site Plan Name:
Project Name:
Building Permit Application
Commercial Residential X
Parcel ID # 4502-501-0898-000-2
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: I
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 4500.00
Sprinklers _ Generator
Sq. Ft. of First Floor:_
_ Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE;
CONTRACTOR:
Name Linda Mullica
Name: Vance R Corbin ,
Address: 712 Nettles Blvd
Company: Dodd Enterprises Inc
City. Jensen Beach State: 51
Zip Code: 34957 Fax:
Phone No. 561-386-9686
E -Mail:
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: EI
Zip Code: 34952 Fax. 335-3310
Phone No 398-2344
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 CMC 1249958
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,5001 or more, a RECORDED Notice of Commencement is required.