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HomeMy WebLinkAboutBUILDING PERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � LJ Permit Number: Building Permit. Application Planning and Development Services Building and Code Regulation Division 2200 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: PROPOSED IP 'O,VEMI Address: Property Site Plan Name: Project Name: DETAILED DE.SCRIPTIO WORK: CONSTRUCT1104 INFORM Ti {+I: Block No. Additional work to be performed under this permit -check all that apply' Mechanical Gas Tank — Gas Piping —Shutters _ Windows/Doors Electric — Plumbing _ Sprinklers — Generator _ Roof Pitch Total Sq. Ft of Construction: M Sq. Ft. of First Floor: Cost of Construction: $ L43J /7 Utilities: —Sewel —Septic Building Height: OWNER/LESSEE: O£3 ., _..OR: - Name 1417i� OUI 5 ��%�' Name: Curtis Sammons Company: Custom Air Systems, Inc. Address: i.� City: State: _�LI Address: 1615 SE Village Green Drive I City: Port Saint Lucie State: FL Zip Code: Fax: Phone No. 14Q - ;yc - Z i I Zip Code: 34952 Fax: 772-335-1968 E-Mail: Phone N o 772-335-3232 Fill in fee simple Title Holder on next page ( if different E-Mail gustairsys@aol.com from the Owner listed above) I State or County License CAC051810 If value of construction is 52500 or more, a RELORDEo Notice oT Lommencememt is requireu. 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 MORTGAGE COMPANY: _ Not Applicable Name: Name: Address. Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: j 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, 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 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." Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA � COUNTY OF vJ. r,�GGGt-� STATE OF FLORIDA COUNTY OF c�Zc oe/ &L _ The fgrToing instrument was acknowledged before me this day of ,`,�P�mbe( , 20ZL by Thefor oing instrument was acknowledged before me Ithis d� day of _66PA l (_ 21 22 f 1/ S 5/F W x it eU t? C I S S/�M M,,2 /2 5- Name of person making statement. Name of person making statement. Personally Known _ OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced �{ 2 (Signature of Notary Public- State of Florida) n oi►�•Y.rUe CHRISTINE 8 EN Commission No.�Ui ©52541 r '^�P Y#0 * J�1 AMY C01!MISSIO EXPIRES:Ap74, (Signature of Notary Public- State of Floric4� fSN rot* .... . CHRISTINE B FNR nission No. ri cs� 4 b MYCON.MISSION;R o� EXPIRES: Apnl 021 ''Fk,ff�oP� BandedThmMgNWIrl REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED eV. 1 52546 9Mces _ v ® 1'MC WIZARD OF EhK i7y2} a44 d :8 i — PRODUCT 211 - - JOB INVOICE cUSTOMI AIR SYSTEMS, INC 2040 Air Conditioning - Appliance Repair CUSTOMERS ORDER NO. D ORDERED 1615 CSt SE Village Greery�l�CjDry — Port ;LIjc{e. FL 3�F 52 ORDER TAKEN BY DATEPRO ISED A.M. (7 2) 335-3232 571-100 PHONE P.M. 21 Q III}' t � � DAY WORK JOB NAME AND IOCATION G CONTRACT EXTRA DESCRIPTION OF WORK e. ti S1 PRICE AMOUNT DESCRIPTION OF MATERIAL USED OUANT. A r2i_ vvc� N i NJ LABOR HOURS MECHANICS @ ---i- a HELPERS I herby acknowledoe the satisfactory ,.=r,,elalion of the above described work. _5ob.vo7 I ` �p.00 AMOUNT TOTAL MATERIALS TOTAL LABOR TOTALLABOR I TAX �r7ATE GOM" ETSA� 1/1OTAL