HomeMy WebLinkAboutBujilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5127120 Permit Number:
O
` Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address. 559 Nettles Blvd Parcel ID # 4502-501-0745-000-5
Property Tax ID #:
Site Plan Name:
Project Name: _
DETAILED DESCRIPTION OF WORK:
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 4500.00
Generator
Lot No --
Block No.
_ Windows/Boors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Sara Millar
Name: Vance R Corbin
Address: 559 Nettles Blvd
Company: Dodd Enterprises Inc
City: Jensen Beach State: _
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34957 Fax:
Phone No. 540-539-8172
Zip Code: 34952 Fax: 335-3310
E -Mail:
Phone No 398-2344
Fill in fee simple Title Holder on next page (if different
E -Mail doddenterpdses@dodd.com
from the Owner listed above)
State or County License CMC1249958
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTY OF '
Address:
Swor or affirmed] and subscribed before me of
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
��
City:
Personally Known OR Produced Identification
Zip: Phone:
Type of Identification
Zip: Phone:
Produced
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencine work or rpeordinrr vniir Nntirp of rnmmc%nranlont
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Signature of owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF '
Swor to (or affirmed) and subscribed before me of
Swor or affirmed] and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this day of 2020 by
this day of 202"0 by
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Name of person making statement.
Name of person making statement.
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Personally Known R 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 }
Commission NZ al)
Commission No.
PU tSM Y Public State C Flonda
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P4,._Notary Public Skate of Florida
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DATE
RECEIVED.
DATE
COMPLETED
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