HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 515!2020
7CO(INTY
F' l Q R 1 D R
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: 538 Nettles Blvd Parcel ID # 4502-501-0724-000-2
Property Tax ID #:
Lot No.
Site Plan Name: ,Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit –check all that apply:
Mechanical
Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 4500.00
— Gas Piping — Shutters
__._ Sprinklers — Generator
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name William Smi
Name: Vance R Corbin
Address: 538 Nettles Blvd
Company: Dodd Enterprises Inc
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No. 518-376-4887
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No 398-2344
E -Mail doddenterprises@dodd.com
State or County License CMC1249958
E -Mail:
Fill-in fee simple Title Holder on next page (if different
from the owner listed above)
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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
-,)C Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTY OF
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:.
Address:
Not Applicable
BONDING COMPANY:
Name:
X—Not Applicable
Address:
y
City:
Personally KnownOR Produced Identification
City:
Type of Identification
Zip: Phone:
Produced
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with arsy applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult *ith 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.
V,
i'�
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:'
Rev. 2/7/19
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDASTATE
OF FLORIDA
COUNTY OF �--
COUNTY OF
The forgoing instryinent was acknowledged before me
this day of 20 O'D_ by
The forgoing instrument was acknowledged before me
this -5day of b 20t5b by
Name of personstatement.
Name of person making statement.
`making
y
Personally KnowlS OR Produced Identification
Personally KnownOR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida }
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Comm!rI,'
Commission No. (Seal)
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RECEIVED
DATE
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Rev. 2/7/19