HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��I � Permit Number: 10
Building Permit Applicati®n
Planning and Development Services �% %
Building and Code Regulation Division QG'
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:
PRC POSED,IMPtOVE'MENT, OCATIQ(V:_`
Address: 7854 MEADOWLARK LANE PORT ST LUCIE FL 34952
Property Tax ID#: ��Y � l()� (�l( f Lot No.
Site Plan Name: Block No.
Project Name:
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DET'-AILED DESCRIPTION OF WaRK
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AC CHANGE OUT LIKE FOR LIKE 3.5 TON 15 SEER R410A 10KW HEAT
CO.N5TRUCTlON INFORMAT{ON
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: Sq. Ft. of First Floor:
Cost of Construction:$ 4700 Utilities: —Sewer —Septic Building Height:
OWNERJLE5SEE CONTRACTOR
Name PAM PRICE - "---- Name:DAVID SMITH
Address:7854 MEADOWLARK LANE Company:ONE CALL AIR CONDITIONING
PORT ST LUCIE 968 SW PROVINCETOWN LANE
City: State:_� Address:
Zip Code: 34952 Fax: City: PORT ST LUCIE State:
Phone No.7728280457 Zip Code: 34953 Fax:
E-Mail: Phone No7722013885
Fill in fee simple Title Holder on next page(if different E-Mail ONECALLCOOLING@GMAIL.COM
from the Owner listed above) State or County Lice nseCAC 1817403
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.
SUPPLEMENTAL.CONSTf�UCTION l IFN LAW INFORMATION
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
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.
In consideration of the granting of this requested permit, I do hereby agree that.l 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 LE R AN ATT RNEY BEFORE RECORDING YOUR NOTIC MENCEM_WT"
bSjgn ture of`bwner/Lessee/Contractor as Agent for Owner nature of Contractor/License Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L-a COUNTY OF Ls�,—
The forgoing instrument was acknowledged before me The f r oing instrument was acknowledged before me
this i K_day of lrF3 20,2D by this day of t=;e2 20_'Ca)by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced (�(, Produced (_ (J�
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(Signature of Notary Pu t-ltateolllorida,
(Signature of Notary Publ - ball P
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Commission No. �o eL ' =; =State V4UGHN
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COUNTER REVIE REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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