HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Sl(O I a D OLO Permit Number:
- 3 _ V
Building Permit. Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE:
Address: a? U ��r7 � el � h V-10-1
Property Tax ID #: 3 "I I � - � J � r � ~wy � � — Lot No.
Block No.
Site Plan Name:
Project Name:
DETAILED DES01PT16N.QF
1 /1te �y�r L11�� Z s +� Sys $c 4f
Additional work to be performed under this permit -check all that apply:
/ Shutters Windows/Doors f.� Mechanical — Gas Tank — Gas Piping _ —
nnklers Generator Roof _ Pitch
Electric —Plumbing — Sprinklers — —
Total Sq. Ft of Construction:: Sq. Ft. of First floor: _
Cost of Construction: $ / / 0 O Utilities: _Sewer _Septic
Address: �'� hJ 11200-L-1 t �i
City: Po r f SQ l ire' V et`e- State f -L
Zip Code: 3 Lf �' 3 Fax:
Phone No. 77 a' 5 7 q' 0&1
E -Mail: .
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Building Height:
Name: Curtis Sammons
Company: Custom Air Systems, Inc.
Address: 1615 SE Village Green Drive
City: Port Saint Lucie State: FL
Zip Code: 34952 Fax: 772-335-1968
Phone No 772-335-3232
IIE -Mail custairsys@aol.com
State or County License CAC051810
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: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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, 1 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."
e
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA& (7 STATE OF FLORIDA G
COUNTY OF IFL�6-- COUNTY OF J't d uz!c�
The forgoing instrument was acknowledged before me The forgo,instrument was acknowledged before me
this (o day of ►M 4 �_, 20 7L6 by this day of i� 4 � 20 Dby
Lih t/S S6n1X0nS eURT1S 6/MM63/25-
Name of person making statement. Name of person making statement.
Personally Known Ja._ OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
DATE
RECEIVED
DATE
COMPLETED
(Signature of Notary Public- State of
fforida }
(Signature of Notary Public- State of Flori
CHRISTINE B E
Commission No. 40 �s25�6
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REVIEWS
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PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED