HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I M 1�'{ ��
Date: 11/2112019 Permit Number:l 1 I 1 `
- RECEIVED
Building Permit Application
Planning and Development Services N O V 2 2 2019
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Resid
PERMITTYPE: MECHANICAL —P*tW 40-y-
# R( P®51= ` IVlPRtllEi+lIENT LQaTItI
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Address: 221 OLIVE AVENUE
Property Tax ID#: 3419-510-0277-000-3 Lot No.
Site Plan Name.: Block No.
Project Name:.TODD WELSH
Cil` > ILE9, ECRtPT10�N C7F`UItORK
DUCT WORK.CHANGE OUT TO ALLOW BETTER AIR.FLOW IN HOME,DRAWING ATTACHED.
COIVSTRUi ifl l:lelfMATION
Additiol 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: Sq.Ft.of First Floor:
Cost of Construction:$ 4394.00 Utilities: —Sewer _Septic Building Height:
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t3lVNERJLESSE€ .. CQNTRACTC?R
Name TODD WELSH Name:FREDERICK MILLER
Address:221 OLIVE AVE Company:MILLERS CENTRAL AIR, INC.
City: PORT ST LUCIE State:_ Address:20 VII INTERLAKE BLVD
Zip Code: 34952 Fax: City: LAKE PLACID State:FL
Phone No.561-512-9330. Zip Code: 33,852 Fax: 772-344=6480
E-Mail: Phone No 772-785-8080
Fill in fee simple Title Holder on next page(if different E-Mail OFFICE@MILLERSCENTRALAIR•.COM
from the Owner listed above) State or County License CACO5.8675
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.
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SU PLEiV ENTA' L CC}I AU.CTI .N:L(51 LAW I !'`FORAT 10
DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City State: City: State:
Zip: Phone Zip: Phone:
;I
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name:, Name: i
Address: Address: l
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 with your Home Owners Association and review your deed for any restrictions which may apply.
Inconsideration 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, TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
SignatureofOwner essfee/Contractor as Agent for Owner Signature of Contractor/License Holder
;STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF Sk,. ie, COUNTY OF jl
The oinginstri Merwaacknowledg before me The oing instrurrieni was ac�knowledg before me
this day of �� t� 20 by this day ofIV�LA z0 by
V& w 6(L "�i 1W
Name of person mak.ing.statg ent. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification I
Produced Produced
tVIN
ign"ature of Notary Public-Stat R "+)tAl febfdary 1 i atu a of Notary rar ° �,FF°614
t �S10lJ
EXpVRia da, �Q� a cam^ �. Febma 16.Zd20
ass '� XPIRES,`�p5�
Commission No. �!) Commission No. ral}sQ��
�AUy,gi)8-053
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION. SEA TURTLE MANGROVE!
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev. 2/7/19
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