HomeMy WebLinkAboutBUILDING PERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C�-- l a' I Permit Number:
•
a
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: 10855 Henrys Road
Property Tax ID #: 2321-501-0003-000-1
Site Plan Name:
Project Name: Lynn-Redidence
Building Permit Application
Commercial Residential xxxx
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
Like for Like A/C system replacement
15 Seer, 9 KW, 4 Ton, Ground, Closet
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
Mechanical — Gas Tank — Gas Piping _ Shutters
— Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 6795.00
Generator
Sq. Ft. of First Floor:
_ Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Frederick L Lyman II
Name: Don Miranda
Address:10855 Henrys Road
_
Company: Miranda Plumbing & Air Conditioning, Inc.
p Y�
City: Fort Pierce State: _
Zip Code: 34946 Fax:
Phone No,772-785-9876
Address:750 NW Enterprise Drive
City: Port St Lucie State: FL
Zip Code: 34986 Fax: 772.621-2885
Phone No772-878-5123
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Ldiodato@mirandacompanies.com
State or County License CAC1815486
n .. — v bWlIJLI ul.Lw11 IJ .;tG7uU ur murk', a MMUKury rvorice or commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address.
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name: --- ---- ------
Address:
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 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 BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
R LENDER OR AN TTORNEY BEFORE RECORDING Y OTIC- OF COM CEMENT."
YA,
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFs+Lml. COUNTY OFS11-me
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ,-1day of ' 20 T by this Ja day of ee0, 20_�J by
DON j MIRANDA Don J Miranda
Name of person making statement. Name of person making statement.
Personally Known — OR Produced Identification Personally Known xxX OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public- S to of Florida) (Signature of Notary Public- gp/of Florid ]
t ,��ori atodate �•1/ -r` �.brl 010d90
Commission No. _ � COCM M01on # G0069258 Commission No. = COm 90P GGIXV58
. Expires: Feb. 9, 2021 .y' Expires: FAb. 9, 2021
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- Wary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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