HomeMy WebLinkAboutVan Alstine, James Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _/ 01 - I - 2-
Permit Number:
L C
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial Residential X
CBDG Funding
Address: 8320 Muirfield Way, Port St Lucie, FL 34986
Property Tax ID #: 3328-802-0045-000-5
Site Plan Name: Vanalstine
Project Name:
New Electrical Meter Second Electrical Meter
(Affidavit rani irarl)
Lot No. 42
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
Total Sq. Ft of Construction:
Cost of Construction: $
Name James R Nichols Jr
Address: 532 NW Mercantile PI, Unit 111
_ Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer —Septic Building Height:
City: Port St Lucie State: FL
Zip Code: 34986 Fax: N/A _
Phone No. 772-871-1560 E-
Mail:_permitting (@ speedyacservice.corn
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: James R Nichols Jr
Company: Speedy Air Conditioning Service
Address: 532 NW' Mercantile PI Unit 111
City: Port St Lucie State: FL
Zip Code: 34986 Fax: N/A
Phone No 772-871-1560
E-Mail permitting cDs eed acservice.com
State or County License CAC1820639
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 !AW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY:
Name: Name: X Not Applicable
Address: Address: —
City: State: City:
Zip: Phone Zip: Phone: State:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 conflicts with any. applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 fa'lure to Record a Notice of Commencement may result in paying twice for
improvements to your pr • p rty. A Notice of Commencement must be recorded in the public records of St.
Lucie County an osted n �jobrfe Eefore the first inspection. If you intend to obtain financing, consult
with lend ore an att ore commencing work or recording our Notice of Commencement.
Signature wR-Iresse ontract r as Agent for Owner
STATE O FL RI
COUNTY F
Sworn to (or affir nd sub abed before me of Physical Presence or Online Notarization
thisZLkj day of PI'' 20 Z( by
4—
Name of person making statement.
Personally Known OR Produced Identification
TyperRf Identification Produced
(Sjgnature_ct Notary Public- State of Flo ida)
Commission No. Q G ~7 73 1~7 I (Seal)
�`► Notary Pubic Suite of Florida
Stephanie Spurlin
My Commission HH 057731
a n Expires 10/27/2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE REVIEW REVIEW
RECEIVED
DATE
COMPLETED
Rev 5 20 21