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HomeMy WebLinkAbout20191111112551All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date 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 Number: Building Permit Application Commercial Residential xxx PERMIT TYPE: P flPQSED IMP"I'l ENT LflCA`Ti�N ` Address: )- 2.0 ::Von r4— &-Lk Property Tax ID#: 34 16'--1(7etc)L, a 0.- ofo (v Lot No. Site Plan Name: q_ )„,_%r C1 Block No. Project Name: 4`Xya O.w, 6 V cry Additional work to be performed under this permit — check all that apply: &_Mechanical _ Electric _ Gas Tank Total Sq. Ft of Construction: _ Gas Piping _ Sprinklers Shutters Generator Sq. Ft. of First Floor: Windows/Doors Roof Pitch Cost of Construction: $ 71 `s® V�XQ Utilities: —Sewer —Septic Building Height: Name .5AQ `jam LL r Address: L,-S,,— City: VC3 State: FL Zip Code: 3 ?4 q j5e2 Fax: Phone No. `BSI. 6 "1 0 2., — E-Mail Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Jeffrey Lindstrom Company: Lindstrom Air Conditioning Address: 3581 W McNab Rd City: Pompano Beach State: FI Zip Code: 33069 Fax: Phone No 772-600-4088 E-Mail dulcem@lindstromair.com State or County License CAC056971 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. 5UPPLEMENT;4L CaNSTRUCTlC7N LAN LA1t NFt7RMAT1fJf r,.. �... 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: j 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 bylaws rules, 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 OBTAIN FINANCING, CONSULT POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF Y0AQI INTEa,19MMENCEMENT." WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR OTI E Signature of Owner/ Lessee/Contractor as Agent for Owner SignarLpfrUof Contra or/License Holder STATE OF FLORIDA STAOF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20_ by this _LX_ day of JJtj yQ _ 20�_J by Name of person making statement. Name of person mJlking statement. Personally Known OR Produced Identification Personally Known VS?(oxOR Produced Identification Type of Identification Type of Identification Produced Prod e P DULCEMARTINEZ mis+l<l'onn # G6103391 ' xpires May 20ry21 N10, H�d9et atn$�ftl{fAP (Signature of Notary Public- State of Florida) ignature of No ary Public- Stat of or a ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev; 1