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