HomeMy WebLinkAboutBuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/22/2021 Permit Number:
O
w 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: 1237 Nettles Blvd Parcel ID # 4502-501-1424-000-6
Property Tax ID #:
Site Plan Name: _
Project Name: _
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK: I
Change out 2 ton 16 seer Carrier st cool split system 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 T Shutters _ Windows/Doors _ Pond
Electric — Plumbing _ Sprinklers T Generator _ Roof Pitch
Total Sq. Ft of Construction: —
Cost of Construction: $ 5000,00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Thomas Forkan
Name: Vance R Corbin
Address: 1237 Nettles Blvd
Company: Dodd Enterprises Inc
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No. 772-229-2420
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No 398-2344
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the owner listed above)
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:
X_ 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:
XNot 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 pplicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult wit. 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 vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License FEolder
STATE OF FLORIDA
<k (tLC.t11e_
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Swor to (or affirmed) and subscribed before me of
Swoto (or affirmed) and subscribed before me of
�/ Notarization
Ph sical Prese ce or Online Notarization
J�day
Physical Prese ce or Online
by
this of 24N by
this ffj day of`
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Name of person make g statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida );
(Signature of Notary Public- State of Florida )
Commissiont4o. (Seal)
Commission No. (Seal)
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Notary u
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SUPERVISOR
PLAN
Suzette Ritchie
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REVIEW
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1
REVIEW
DATE
RE, EI D
DATE
COMPLETED
Rev. 5/6/20