HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/3/2020 permit Number:
g ` 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: 1055 Nettles Blvd Parcel ID ## 4602-501-1242-000-6
Property Tax ID #:
Site Plan Name: _
Project Name:
DETAILED DESCRIPTION OF WORK:
Change out 2 1 /2 ton 15.5 seer Rheem heat pump split system 5 kw heater like for like
New Electrical Meter Second Electrical Meter
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 Pond
Electric —Plumbing _ Sprinklers Generator _ Hoof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 5000.00
Sq. Ft. of First Floor:
Utilities. —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Shawn Martin
Name: Vance Corbin
Address: 1055 Nettles Blvd
Company: Dodd Enterprises Inc
Address: 1296 SE industrial Blvd
City: Jensen Beach State: _ _-_
Zip Code: 34957 Fax:
Phone No. 330-283-3232
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
City: Port 5t Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No 398-2344
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 HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _. Not Ap
Na me: '
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE MOLDER: _.& Not Applicable
Name:_
Address.
City:
Zip:
Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 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 attorney before commencing work or recording your Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signaomture of Contractor/License bolder
STATE OF FLORIDA
STATE OF FLORIDA _ 't
COUNTYOF -�
COUNTY OF C�(� ,
Swor o (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Pres nce or Online Notarization
d/ ysicai Pr es nce or Online Notarization
this a day of 2020 by
this day of 2020 by
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U6a11e-C�1
Name of person making statement.
Name of person making statement.
iI
Personally Known%'ZOR 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 )
C m i n N �y o u„h,. &ate of Florida (Seal)
Commission No. (Sea])
r° Suzette Ritchie
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ff M Commission GG 135736
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rr, Notary Public State of Florida
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REVIEW
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REVIEW
DATE
RECEIVED _.
DATE
COMPLETED
Rev.5/6/20