HomeMy WebLinkAboutMirabito Permit PacketAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0-6,3-,:IodC Permit Number:
Lum
O
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: G hY1 3 ),tJ(1y 5q r)k L UC i C. i Ft- S9 T �(r,
Property Tax ID #: 33a-+ - 169 - 00 15- 0i00 r Lot No.
-
Site Plan Name: Block No.
Project Name: ._ 0
DETAILED DESCRIPTION OF WORK:
HVAC CL'12049, 12ul t KC GL, Ii KC 16 a 3:5 Jtn fy Seer R1eern coo(IJ Smi�l Sys{ m
i�ti�� I(�Kti+ eco{- �a✓�r) /�y �l�C�- C(K
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 _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _3; 1Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name ae)
Name: Robert Noeker
Address: UnKs W w (
Company:Service Star Air Conditioning and Heating
City: ?y14 5,irA 1 vt i P. State: F(,
Address:18735 E. Colonial Drive Suite 100
Zip Code: a'19FC,) Fax:
City: Orlando State: FL
Phone No. (a.� I -.
Zip Code: 32820 Fax: 407-568-2766
E -Mail:
Phone N0772-770-3733
Fill in fee simple Title Holder on next page ( if different
E -Mail info@servicestarcoolingandheating.com
from the Owner listed above)
State or County LicenseCAC055550
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
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
Not Applicable
State. --
Not Applicable
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.
I
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OFP,}'('f -q e
Sworn to (or affirmed) and subscribed before me of
hyy��sical Presence or Online Notarization
this Y�-tdayof�G'\A4 ' � 2020 by
Name of person making statement.
Personally Known 4 OR Produced Identification
Type of Identification
(Signature of Notary Publ`9 State of Florida )
Commissi n,t'"oi .. AMANDA LITTLE Seal
Notary Public . State of Florida
Commission GG 915595
Dire SREVIEW s M rough Nitional Nota Assn.
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF c ro y tib.
Sw9rn to (or affirmed) and subscribed before me of
a" Physical Presence or Online Notarization
this,3l��day of (:NeMb� 2020 by
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
1-4,
�.
(Signature of Notary Pub ' - tate of Florida )
AMANDA LITTLE
Notary Public - State of Flor
Commission # GG 915595
SUPERVISOR
I REVIEW REVIEW ugh tIREVIE+W �n I MREV EWVE