HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/20/2020
PrOUNTY R 17
F L 0 R f 0 A'"
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 TYPE: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Permit !Number:
Building Permit Application
Commercial Residential x
Address: 1257 Nettles Blvd Parcel ID #i: 4502-501-1444-000-2
Property Tax 1D #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Change out 3 ton 15 seer Rheem st cool split system 10 kw heater like for like
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional 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: _
Cost of Construction: $ 4700.00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: Amw
CONTRACTOR:
Name Kathleen O'Connell
Name: Vance R Corbin
Address: 1257 Nettles Blvd
Company: Dodd Enterprises Inc
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No. 772-229-7904
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No 398-2344
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail doddenterprises@dodd.com
State or County License CMC1249958
If value of construction is $2540 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
V
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.
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 IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE ,b;M''D
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."
Rev. 2/7/19
Signature of Contractor/License Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA (6 j,�
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COUNTY OF 1
COUNTY OF
The for ping instr gent was acknowledged before me
The forgoing instru. ent was acknowledged before me
this 0A day of 20�c7 by
this day of 20 _*0 by
Name of person making statement.
Name of person making statement.
V
Personally Known OR Produced Identification
Personally Known OR Produced identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Com i55,JW1v o. Nota Public State of Florida (S 1)
(Seal)
I Suzette 1 c lei
My Commission GG 135736
pU. Notary public State of r orid.
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SUPERVISOR
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COUNTER
REVIEW
REVIEW
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REVIEW
DATE
-
RECEIVED
DATE
COMPLETED
Rev. 2/7/19