HomeMy WebLinkAboutBuilding Permit Application Jan 28 2021 2:07pm LOUIE'S AIR CONDITIONING 772-429-5267 p.1
All APPLI BLE IJ4F0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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)462-2578
PERMIT APPLICATION FOR:
PROPOSEDIMPROVEMENT LOCATION:
Address: L d/C) ?, D I - ►�,
Property Tax ID#: 39 a (el-, -U t 1- ` O O L3 - Lot No. ao�
Site Plan Name: Block No. a
Project Name: '� S
DETAILED DESCRIPTION WORK:
/ Y S
LA
U l
s 0 t4 40,1 Ly Liu ID o
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Add iti al 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:: Sq. Ft.of First Floor:
Cost of Construction:$ `� i �� Utilities: ,Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name ? Name: (.OV i J a W ;
Address: L)• r Company:�Ata-k'S
City:FIC. ilet- 6•e- , State:^ Address:_(0 3 1 �'�--
r
Zip Code: 246t -Fax: City:?OcV S4-• o 1-�•� Stater
+-
Phone No. �L� � _I`�4' Zip Code: N66_A Fax: %4A4R•se;��
E-Mail: C-616- Phone No
Fill in fee simple Title Holder on next page(if different E-Mail v C—L
I �
from the Owner llsted above) State or County License_^A& ?Z'
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.
Jan 28 2021 2:07pm LOUIE'S AIR CONDITIONING 772-429-5267 p.2
I
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: i 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:
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 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 our Notice of Commencement.
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Signature of Owner/Less /Contractor as Agent for Owner "nature of Contractor/License Holder
STATE OF FLORID STATE OF FLORI
COUNTY OF �• ��3 c-ICr COUNTY OF �• L� C.. l C_
S rn to(or affirmed)and subscribed before me of S n to(or affirmed)and subscribed before me of
Physical Pre ence or Online Notarization hysical Pres nce or Online Notarization
this day of 2020 by is �day of 2024 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known)0 OR Produced Identification
Type of Identification Type of Identification
Produ d t , ` Produc d
(Signs Notary Public-StaAMY ff P1:OR re o otary Publicli
-
1 AMY K.PEMSON
COMMlSSIOti#GO 939876 Ll 'r%
Commission No. 1 _ a pIRE&D)ecembart .0Vm ion No. lJ �L M1(�AM)IISSION#GG93987
%'•k of n?` ga„d� Nomty PuDOc U rs y A� EVIRES:December 15,2023
"�'o:iC�`• Thru Notary Public und;;;rs
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
�ev. 576/20