HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 oR 01119 Permit Number:
s
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential -
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: ` ry
Legal Description: V 1 yl l+
Property Tax ID ff bt—
Site Plan Name:n-i�n
Project Name: Exninre ( ffir)
Setbacks Front Back: Right Side: _
DETAILED DESCRIPTION OF WORK:
Replace AC, exact change out with Eton,
onai worK to ne nerformea
HVAC Gas Tank
Electric 0 Plumbing
unaer tnis permit — ct
❑Gas Piping
Sprinklers
Left Side:
SEER, KW AC unit
apply:
Shutters
Generator
Lot No.
Block No.
Windows/Doors
11 Roof hoof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $� ,,,,-_ Utilities:Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name; Dennis Zacek
Address.
Company: AIRS American Residential Services
City: State:
Address: 2800 US Hwy 1
Zip Code: Fax:
City: Vero Beach State: FL
Phone No._1_13-GCq_ [--1( 57
Zip Code: 32960 Fax:
E-Mail:
Phone No.
Fill in fee simple Title Holder on next page ( if different
E-Mail:
from the Owner listed above)
State or County License: CMC1249753
it value or construction is ,iZWU or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: x Not Applicable
Name:
Address:
City:
Zip: Phone:
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.
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 vour Notice of Commencement.
_ Signature of O er/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF sLLume
The fo ing instr acknowledg fore me
this -day of 20 4by
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No I tc2E (Seal)
COLEEN SLILLIVA
*. My COMMISSION # GG0715<
Revised 47115/2014 ::��. EXPIRES February 09, 2021
s
Signature of Contra r License Holder
STATE OF FLORIDA
COUNTY OF SlLucie
Thef��inglnstrtT a as acknowledgefore me
this day of 20 by
Dennis Zacek
( m person ackno dging }
ftfi (
(Slgnature of Notary Pu a of Florid }
Personally Known X OR Produced Identification
Type of Identification Produced
Commission No. 61�55!; (Seal)
1 r•nr FEN SUL.LIVAN
ti «_ My COMMISSION s "" 2
49,421
' EXPIRES February
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