HomeMy WebLinkAboutBuilding Permit Application-original;kII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l 2� �Permit Number:
-I J memo -
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: A/C CHANGE OUT
PROPOSED IMPROVEMENT LOCATION: 2700 N. HWY AlA#306
Address: 2700 N. HWY Al A #306, FORT PIERCE FL 34949
Property Tax ID #: 1425-704-0016-000-4
Site Plan Name: AQUANIQUE
Project Name: HETZEL
DETAILED DESCRIPTION OF WORK:
INSTALL 2.5 TON BOSCH WSHP SYSTEM
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit —check all that apply:
A Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: l O.L�4I
Cost of Construction: $ L-Vbc0
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name lone Hetzel
Name: Joshua Roberts
Address: 2700 N. HWY Al A # 306
Company: Air Docs of the Treasure Coast, Inc
City: Fort Pierce State: `l�/
Zip Code: 34949 Fax:
Phone No. 772-579-1755
Address: 866 12th Ave SW
City: Vero Beach State: FI
Zip Code: 32962 Fax:
Phone No 772-713-7716
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail air docs_adm @yahoo.com
State or County License RA13067525
If value of construction is 52500 or more, a RECOKDEU Notice or commencement is requireu.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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DESIGNER/ENGINEER: — Not Applicable MORTGAGE COMPANY: Not Applicable
_
Name: Name:
iAddress: Address:
City: State. City: State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLD : Not Applicable BONDING COMPANY: Not Applicable
Name:_ Name: i
Address: / Address:
City: City:
2ip: Phone: Zip: Phone:
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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 that
covenants 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/ Lessee/Cont actor a gent for Owner
Signatures& Contractor/Lreense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Indian River
COUNTY OF Indian River
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 26 day of November 20_ by
this 26 day of November 20_ by
!one Hetzei
Joshua Roberts
Name of person making statement.
Name of person making statement.
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Personally Known OR Produced Identification x
Personally Known x OR Produced Identification
Type of Identification • r ��y
Produced_ Drivers Lic # "�(,'
Type of Identification
-aLg—l✓
Produced
(Signa-'Sfat� l
� MY COMMISSION # GG 170551
��. l., EXPIRES: i r,2��2021
Commission No. �ers
(Signatur of Not
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��- _ _ L.•�;.: GWENDOLYN i. BELL
MY
Commission No. :or •_ IAYCOMMISS¢G 17JS51
iRE5:Ce�bar25.2021
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION SEA TURTLE
I MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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