HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC INP MUST BECOMPLETED FOR APPLICATION TO BE ACCEPTED
Date; d w
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CiEAVTY
RECEIVED
Ouilding PermitApplication
SEP 3 0 2019
Planning and DevElopmEntSErvices
Building and Code Regulation Division
PermittingST. Lucienty,
II Virginfa •
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
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Additional workto - . ormed under this .- ixTi . ..
WHVAC GasTank Gas Piping Shutters Windows/Doors
Electric Plumbing []Sprinklers Generator Roof Roof pit
Total Sq, Ft of Construction, Sq. Ft.of First Floor:
Ln Cost of Construction.$ r� �MSewer
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A•• en D 0 t company:
Zip G
.a■ i
Phone • . ••
• r
Title -19
Fill in fee simple Holder on nextdifferent E-Mail," [ .► raj ��� •
from owner listed above) or •
If value of construction is 0. or mori
a RECORDED
7 A
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: Not Applicable
Name* N217ne•
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 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 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 on the jobsite
before the first inspection. if you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Slgnature o r/Lessee/Contractor as Agent for owner Sign ontrac r/License Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OF COUNTY OF '-T: I-LL Ck,
The forgoing instrumen was cknow
" ledged before me The forgoing h5"men.was a knowledge before me
this5Q day of 20 ik by this day of mber,20M by
Name of person makq statement Name of person malfflig statement
Personally known -Y OR Produced identification Personally Known L OR Produced Identification
Type of identification Type of Identification
Produced Produced
(Signat a of u (Signature o;tNstPublic-8:ate.�f6Ak1b)
,gryAL A g' ° Notary Public-State Of Florida
Commis ' ,1V .- Nowy �stall 2FF 9�s Commi corrui►tssion!�FF gi My Ca n.E*res 09 B.2014 ' an&I aNOY.. Nriami
REVIEWS FRONT ZONING SUPERVISOR PLAINS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev,8/2/17
RC-CETv _L)
set, 30 2oi9
FLORIDA ENERGY CONSERVATION CODE sT Lucie
county,
ST, Lucie county, Permitting
Mandatory Duct Inspection Certification for HVAC change-out
For use when part of the duct and/or HVAC system has been replaced(Section 101-4.7.1.1 &FS553,912)
Owner: Contractor name; ALL AD*IZICAN AIR&ELF-CTRIC,INC
street-address: V1-i G�w ori jurisdiction:
city: V
Permit NO.:
zip: Final inspection date:
i certify that I have inspected the duct work associated with the HVAC unit referenced by the permit listed
above and found it complies with the requirements of Section 101.4.7.1.1 as indicated below-
qP Where needed,the existing ducts have been sealed using reinforced mastic or code-approved
equivalent.
0 Ducts are located within conditioned space, (Section 101.4.7,1.1 exception 1)
0 The joints or seams are already sealed with fabric and mastic(Section 101.4.7-1.1 exception 2)
0 System ed{see below)and repairs were made as necessary—(Section 101.4.7.1,1 exception 3)
SigaK;re: Date•. ODi.1-20fig
Printed Name: 'V�a�
Contractor License 4.- CAC057965
I certified I have tested the replaced air distribution systern(s)referenced by the permit listed above at a
pressure differential of 25 Pascals(0.10 in-w.c.).
Signature: Date:
Printed Name:
Form raAslon date:March is,2011