HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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."
L�iLLG /_ L1. -
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA 1
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STATE OF FLORIDA `, .
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The forgoing instru e t was acknowledged before me
this day of 20 D by
The forgoing inst um nt was acknowledged before me
this day of 20 —"b by
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Name of person making statement.
Name of person making statement.
Personally Known 1/ OR Produced Identification
Personally Known (, OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of Notary Public- State of Florida ]
(Signature of Notary Public- State of Florida )
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v ry Notary Public State of Florida
zs �� Suzette Ritchie
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REVI VF° Wd SUPERVISOR
Commission No. Seal
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°Suzeto Ritchie
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REVIEW REVIEW
REVIEW xptt
VIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/3/2020
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Planning and Development Services
Building and Code regulation Division
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
PERMIT TYPE: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential X
Address: 159 Nettles Blvd Parcel ID ## 4502-501-0345-000-1
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Change out 2 ton 16 seer Rheem st cool split system 8 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: $ 4400.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Martin Connor
Name: Vance R Corbin
Address:159 Nettles Blvd
Company: Dodd Enterprises Inc
City. Jensen Beach State:
Zip Code: 34957 Fax:
Phone No. 954-309-7463
Address.: 1296 SE Industrial Blvd
City: Port St Lucie State: Fl
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 $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.
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