HomeMy WebLinkAboutBuildinmg permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
_XNot Applicable
Name:
Name:
Address:
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 vmth 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."
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA�
COUNTY OF
COUNTY OF
The forgoing inst,. Pnt was acknowledged before me
this _ day of 20( by
The far oing instru�n nt was acknowledged before me
this day of '��VV 20_Q by
Name of person making statement.
Name'of person making statement.
Personally KnownvngOR Produced Identification
Personally Known 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. 1}
Commission No. (Seal)
Notary Public State of Florida
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G 135736
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SUPERVISOR
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MANGROVE
REVIEW
REVIE
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
Hev. Z/1/19
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/21/2019 Permit Number:
s
Building Permit Application
Planning and Development Services
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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 476 Nettles Blvd Parcel ID # 4502-501-0662-000-9
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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 Windows/Doors
Electric Plumbing , Sprinklers ^ Generator Roof Pitch
Total Sq. Ft of Construction: __._
Cost of Construction: $ 4000.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Diane Whalen
Name: Vance R Corbin
Company: Dodd Enterprises Inc
Address: 476 Nettles Blvd
City: Jensen Beach State:
Zip Code: 34957 Fax:
Phone No.772-485-7364
Add ress:1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
E-Mail:
Fill in fee simple Title Holder on next page (if different
Phone No 398-2344
E-Mail doddenterprises@dodd.com
from the Owner listed above)
State or County License CMC1249958
if value of construction is 52500 or more, a RECUKLML) rro-Esce oT Lornmencemem 15 reyuireU.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.