HomeMy WebLinkAboutBuilding permit applicationALL APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Commercial
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
y
k
Legal Description:
condo �,
YA ovo fa_N*' Qfflye IP 'Mmafm
ttemp
Property Tax ID 11:M i9
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Lot No.
Site Plan Name:
Block No.
Project Name: 1
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 ertormed under this permit — check
a apply:
.tYHVAC Gas Tank ❑Gas Piping
_ Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers
[]Generator Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor.
Cost of Construction: $ � Utilities
:Sewer 0Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Nam � .
Name: Dennis Zacek
Address:
Company: AIRS American Residential Services
Cit : n Stater
Address: 2800 US Hwy 1
City: Vero Beach State: FL
Zip Code: Fax:
Phone No. c
Zip Code: 32960 Fax:
E-Mail:
Phone No -I -tGk -7 [)�
Fill in fee simple Title Holder on next page (if different
E-Mai suI I MOV) aY"v
from the Owner listed abgvej
State or County License: CMC1249753
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
VPPLEMENTAL40NSTROT
DESIGNER/ENGINEER: x
LIEN LAW INFORMATION::
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:
x Not Applicable
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, wails, 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 01,Werl Lessee/Agent
STATE OF FLORIDA
COUNTY OF si Lucie
The for,Rping insfr e wa ac nowledg�fore me
this 0 day of{ 20 l y
aennis Zacek
person
of N
Personally Known x OR Produced Identification
Type of Identification Produced
Commission N O (Seal)
SULLIVAN
Revised 07/15/2014 :r,• sm cor:IrA,GSIory r oGp71s:
/,to.Stid cXPIRES FsL•ruajy G9 2021
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5
Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF stuce
The f going imt u er,t was acknowledged before me
this k..'' day of 20 j _ � y
Dennis Zacek
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. 1 J (Seal)
COLEEN SULLIVAN
h1v cor�rnis��u;v = uuu� �:.•
EXPIRES February 09, 2021
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