HomeMy WebLinkAboutFIORELLI 8721 BALLY BUNION RD.pdfAll APPLICABLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 a 5 �2,& Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Residential
PROPOSED IMPROVEMENT LOCATION:
Address:
PropertyTax ID #: 3'33H �O0" o�i N �`�' y Lot No. 31
Site Plan Name: Block No.
Project Name: e oreW ZAG
I DETAILED DESCRIPTION OF WORK: I
fi 2 -Ion �\ J( I `i S as ✓✓ S40-f
5 k lJ
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ LA3bfl
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: -Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name_ Y_5 �� r 0re
//f.ame: 4 9 LtLV-- b e a 11 -A
company:G,i�fl
Address: g�aI P>a(�� (� o '(�
City: i "4 State: _�
ZipCode:34rtY6 Fax:
Phone No. -:4 xa 8 a - Cr;'jo
Address: (od-11 "e -) -)-r. t c-
cityRZ-4-f�- State:
Zip Code: Fax: -H
Phone No
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
E-Mail VYl�in� i�r N_ brad�rnGi oM• ^^
State or County License CV%60 5g'+g
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.
- ,.' �:: Z. �;. � i9 .rry. � y ' ,� 4� -�•- � �. •5 i` "; �'; nd w�,a�ra�wi �,;,,c,L..,.r r'..y.� t".� 'L4-4t .�.�11JT �v.� ���k'�.w�%,���fy:ii�y ill � �'' L
SUPP- '" :,.�f .n�J lyl. 'iieali r: i:t.1:,., A-n1E .j .�., I�' ,i :�'J`" ti:rt t .,"f ..1: '. .7 - i:( j.. II.y.. =i l,yii<:. `�. SJ•Y if '. "i If 3.- :=Y4 •'+'. 1
.L�MENy•T��► C�_ STg�+ ��.��'�}1/ � ]� �1� �� �lFO �AT�CQN� � ..,r-�-.���r,,,, �, �� � T1i,i _�• `�}F :�_: ,r �:�.= h� ��.3.
•: ;-. y: "rF .R S �` .5'��n. cs.,�c"11;i ,�,.7. ;x ��� +v �.i f: f. .�-. 5� f� ? i�i I � Y • ,}i .1`_l �Ly �5-Y'�. [ L1 �� ��.� fi af� � • f�� .�+
- -�'."nt:.�.:a,��' ..�'.C.�>�..S�L.f. '��l«':rc}?"i ��`_�Ss�r'n�:"�.fF;•:�_ _ ���'•i�..�,_i� �e,:t.p. J_.u`� .-�".fi�::-c-�''.t.t.. '}�i_�{.:'St... :>'ri.
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:
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 per4nit, 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�Ovmer
STATE OF FLORIDA ~'
COUNTY OF
Sworn to (or affirmed) and,subscribed before me of Physical Presence or Online Notarization
this a-S* day of t✓\s20ak by
Name of person making statement. ,
Personally Known � OR Produced Identification
f Identification Produced i
ISydnature of Notary Public- State of Florida)
Commission No. r' 1)106 t'j (Seal) ,t rp,,JESSICA GROVER
Notary Public -State of Florid
_• •= Commission # HH 119064
My Commission Expires
fill%%April 19, 2025
REVIEWS FRONT ZONING SUPERVISOR I PLANS I VEGETATION SEA TURTLE
COUNTER REVIEW RF.VIEW REVIEW REVIEW I REVIEW
DATE
RECEIVED
DATE -
COMPLETED
ev 5/20/21
MANGROVE
REVIEW
UKVWAKD
FACTORY SERVICE
INVOICE
Li COMPRESSOR
U SUCTION PSI
..: �•,'•—_.:�.
_ a'_. .__mil c _
O HEAD PSI
❑VOLTS AMPS
O ELECTRICAL CONNECTIONS
O CONTACTS TIGHT &CLEAN'-
OOIL LEVEL&CONDITION
1-T iq -�
i _
L-,
CALL#
RULED
❑ CONDENSOR COIL
y
DATE
O CLEAN COIL & CHECK FIN COND.
pi
_ —
❑ENT °F LVG_°F
❑ REFRIGERANT
❑122 or&toe
COVERAGES
U FAN AND MOTOR
OVOLTS AMPS
PREVIOUS
CALLS
= .
r' r_F IIAi TT1
O ELECTRICAL CONNECTIONS
'�'
O CONTACTS TIGHT & CLEAN
D FAN PULLEYS(AD3UST BELT)
0CHECK LUBBEARINGS&MOTOR
SERVICE
REQUEST
-
N -
J
❑ EVAPORATOR COIL
O CLEAN&OIL &CHECK FIN
OENTDB—'FILVGDB —T
❑ENi WB—°F LVG WB—°F
,
UCONDENSATEAREAS
❑INSPECT PPN
�
.EANDNNN
❑INSPECT&aCJFiW IXtNN
•—� 1ppPa-�I /,�.1..
UAIR FILTERS
�l���•'
UCLEA ED ❑RERACED
FILTERSI2E
❑ HEATING ASSY.
O BURNER & HEAT IXCHANGER
❑NELSUPPLV ePRESSUPE
OP&OTABSEMBLY
❑FIPMEAA&GWENT
❑PRIMAI YRELAY&FLUE
OFAN&UMn SW IICHOPER
❑BLOWERA59EMBLY
DRVVALVE
OSmPHEAT
ODFFFOUTCYCLE
❑ ELECTRICAL COMPTS.
❑RELAYS OCCNTACmRs
OOVEPLOAD ❑PRESSSMICH
❑THERMOSTAT
_.
DOR. OREPLAGE
ORELOOVE
❑ OUCTSYSTEM
SvTCPRESSURE
Ream -- SUPPLY
FLTER UNRPATNG_
TB.PMVENT_—
Manufacturer PART NEEDED
MODEL# PART NEEDED
SERIAL# _ P.O.#
BM OR# _ P.O.#
DESCRIPTION OF WORK
TECH TIME
TIME
Al "- IN
OUT
• TECH TIME
TIME
#2 IN
OUT
PAYMENT.
I havereceived and agree to {Fie terms and conditions of my contract, and I understand
that thIS service Is a claim galost my contract.
PARTS WARRANTY t'
All Pa as recorded.m wpdaMad as per manufacturerspecifications.
LABOR GUARANTY
PARTS
The labor charge as recorded here
relative to the equipment serviced as noted, Is guaranteed for a peded of 30 days.
---- --
LABOR
We donot, of course, guaranty other parts than Nose we Install. if repairs later become
necessary due to other defective pans, they will be charged sepantely.
No guaranty on any drain stoppages,
i' SERVICE
CHARGE
BFS WILL NOT BE RESPONSIBLE FOR PROPERTY DAMAGE WHEN
REMOVING
OTHER
CI COMPLETE
D PARTS ORDER
ONOTHOME
D RESCHEDULE
TO PERFORM NECESSARY SERVICE WORK AND I ACCEPT - -- i
PERFORMED SERVICE AND/OR CHARGES AS BEING SATISFACTORY TAX
All sales final wittmo adjustments or refund.
X ��bKJ e 17�, 719
CUSTOMER SIGNATURE
wvrw.browardfactory.com
BFS-2 R. 612020