HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTY-
F
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 462-1578 Commercial Residential x
PERMITTYPE:
7 --=Mechanical _ Gas Tank Gas Piping _ Shutters Windows/Doors
PROPOSED IMPROVEMENT LOCATION:
Address: 7321 Sea Pines Ct
Property Tax ID #: 3322-506-0014-000-2 Lot No.
Site Plan Name: Block No
Project Name:
Name Julio Toro
Name: Gregory P Chapdelaine
DETAILED DESCRIPTION OE;WO-R C:
System #1 Like for Like 3 Ton 15 seer 10 kw
City: Port St Lucie State:
Address:491 NW Riverside Dr
Zip Code: 34986 Fax:
City: Port St Lucie State: Fl
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit –check all that apply:
7 --=Mechanical _ Gas Tank Gas Piping _ Shutters Windows/Doors
— Electric _ Plumbing _ Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5800 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Julio Toro
Name: Gregory P Chapdelaine
Address:7321 Sea Pine Ct
Company:AIC Express & Heating LLC
City: Port St Lucie State:
Address:491 NW Riverside Dr
Zip Code: 34986 Fax:
City: Port St Lucie State: Fl
Phone No, 772- 242-1657
Zip Code: 34983 Fax:
E -Mail:
Phone No 772-240-4857
Fill in fee simple Title Holder on next page ( if different
E-Mailacexpress2@gmail.com
from the Owner listed above)
State or County LicenseCAC057139
If value of construction is $2500 or more, a RECORDED Notice of Commencement
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement
is required.
is required.
:SUPPLEMENTALMSMtVC ,1 1:A INFORMATION; .
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 pians, 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 recording your Notice of Commencement. ,f,
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Signatu of ner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA rr
COUNTYOF_-- G(f�
STATE OF FLORIDA
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COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instru ent was acknowfedgeQefore me
this 3 k day of _- -_ �rk v -c- I , 2011 by
this � day of ( 20 by
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Name of per on making statement.
oflorson making statement..
Personally Known OR Produced Identification_
Personally Known OR Produced Identification _-l(�
Type of Identification
Type of Identifici 'on�
Produced - _ ��(A) L
Produced
(Si to f Nota 4r St�r�n elarwa �
16tur N to u lic- State of Florid )
AOLY p '° . lase Tarlo
Co mission No. Notary Public ( of Florida
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Commission NO + r; t r ubllc-StateIR5 d_ba
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of : • My comm. Expires May 8, 2022
Bonded roug at ona Notary ssn.
REVIEWS FRONT ZONING SUPERVISOR
PLANS VE EAI A R L NGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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