HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:! cRU 60 Permit Number:
-
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 ✓y
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: l� al��
34q5c:�
Legal Description: eHurtT k
Property Tax ID It: Lot No.
Site Plan Name: C Block No.
Project Name:,___._.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace AC, exact change out with ton, SEER, KW AC unit
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit— check III apply:
kiVAC Gas Tank Gas Piping Shutters Windows/Doors
_
11 Electric ElPlumbing Sprinklers � Generator � Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
``
Cost of Construction: $ l a Utilities: Sewer Septic Building Height:
OWNERAESSEE: — CONTRACTOR:
Name
Name: Dennis Zacek
Company: ARS American Residential Services
Address: 1
City: State:'
Address: 2800 US Hwy 1
Zip Code: QFax:
City: Vero Beach State: FL
Prone No.37c?~_ .... _
Zip Code: 32960 Fax:
E-Mail: _ _ _ .�
O�
Phone No. 7a � ' -Id►C) .!
Fill in fee simple Title Holder on next page ( if different
E-Mai 6—Ar co-Is
from the owner listed above)
State or County License: CMC1249753
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLIM
DESIGNER)
L:CONSTRUCTION11I 1NI LAW 'INFORMATION:
EER: X Not App
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:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
x Not Applicable
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 1 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 your Notice of Commencement.
_Signature of O er/ Lessee/Agent Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF s,umae
STATE OF FLORIDA
COUNTY OF Mode
The f ing inst ment was acknowledg before me The f Ding instrument was acknowledged before me
this Lday of 20 —by this day of i_� 20 by
Dennis Zacek Dennis Zacek
E
ckn i { p rson ackno le ing
M }
e of Not Pu ic- State of Flo da } ( Mot orida
Personally Known x OR Produced Identification
Type of Identification Produced
Commission N 0c— (Seal)
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. r (Seal)
y.,
r-EN SULLIVAN I I►a:'. •, COLEEN SULLIVAN
Revised 07/15/2014 3 �. rAY CO•"aMls�'cZts 1' C'G�71"�35 ="• '_ FAY COPAhAI
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* '�' EXPIRES February 09, 2021
dF EXPIRES F Lruary 69, 202', '.?orii,.
REVIEWS
FRONT
ZONING
SUPERVISOR
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VEGETATION
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