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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE IN�O MUST BE COMPLETED F Date: SCANNED) • _ �� Luru� Buildi Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 MPLICATION TO BE ACCEPTED Permit Number: RECEIVED Permit Application MAR 2 3 2018 ST. Lucie County, p@rmitring Commercial Residential x PERMIT APPLICATION FOR: To Select fr m dropbox, click arrow at the end of line V�%\o dins 1 PROPOSED IMPROVEMENT LOCATION: Address: 453 Dusk Legal Description: - Property Tax ID #: 2308-601-0049-000/1 l Site Plan Name: - Project Name: Amanda Kessler and Harold Kessler /end Suzanne Kassler Setbacks Front Back: Rig t Side: Left Side: DETAILED DESCRIPTION OF WORK: Install Split Air cond in Mobile home 14 seer with 7 kw heat Lot No. 49 Block No. CONSTRUCTION INFORMATION: Additional work to be nerformed un er t is permit — check a apply: ZHVAC Gas Tank ❑Gas Piing _ Shutters a Windows/Doors Electric ❑ Plumbing Sprinklers 0 Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft. of: First Floor: Cost of Construction: $ 3450.00 Utilities:ln Sewer Septic Building Height: OWNERAESSEE: CONTRACTOR: Name_ 5;�,7 0, x a e. Address: 13' V 3 „4 Name: David Nutting Company: Central air systems Inc City: �'l�, �,�� State: Zip Code: 3 9 S ys Fax: Phone No. E-Mail: Address: 6295 Lake Worth Rd #20 City: Lake Worth State: FI. Zip Code: 33463 Fax: 561 439 6025 Phone No. 561 603 1909 E-Mail: centralairsys@gmail.com Fill in fee simple Title Holder on next page (if different from the Owner listed above) State or County License: CAC 054741 .. — YIdLill a 14. VUU Ul nwre, a Rcwnuru rvoiice oT commencement is required. .,c. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: I MORTGAGE COMPANY: _ Not Applicable Name: David Nutting Address: 453 Dusk Way I City: State: I Zip: Phone I I Address: City: Lake Worth State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicaf le Name: BONDING COMPANY: Not Applicable Name: Address: 6295 Lake Worth Rd #20 I Address: City: I City: Zip: Phone: I 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 alpermit 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 BuildingJCodes and St. Lucie County Amendments. The following building permit applications are exempt from accessory structures, swimming pools, fences, walls, signs, WARNING TO OWNER: Your failure to Record a No improvements to your property. A Notice of Comi before the first inspection. If you intend to obtain commencing work or recording our Notice of Co rgoing a full concurrency review: room additions, rooms and accessory uses to another non-residential use e of Commencement may result in your paying twice for ancement must be recorded and posted on the jobsite nancing, consult with lender or an attorney before mencement. e� as A1'__) dz,2�z Signature of Owner/ Lessee/Contractor gent for Owner Signature of Contractor/License Holder STATE OF FLORWA COUNTY OF and 0 G-� STATE OF FLORIDA k_ OF ���X� L 1 �Q COUNTY The forgoing instrument was acknowledged before me this o2oZday of 4.1^C.tN . 20a by The forgoing instrument was acknowledged before me this day of H2f 6x 20&_ by c.- Q C .er•._ Name of person making sta ment Personally Known OR Produced 01� iir1UNWI& I Name of person making state1nent \���� J(••.:•'�;;F Personally Known OR Produced Ide\ Ifi t� N�Xa'• Type of Identification �NWq/T� Produced 'Pt,4t— N3So2 (�Q '•• �ii Type of Identification J�� �e Produced FOAL— N3�oZl�CC- sii •Gp 12,2 �•• I % . = . • (Signature of Notary Public- StatCW*lorida) #'Fp 132202 : lQ •• (Signature of Notary Public- State of Florida'�-� ��'• •'• ���/ y�BLIC, i 2 2 Commission No. / 02 i �j� (seal) •� S1P`� Commission No. tiG� 13�� 2 (Sea l)7�////�111111111% Ac REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED tev. 8/2/17