HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: mo 'Ely
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Building Permit Application Pe
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Planning and Development Services St• Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 _ t� 01
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical W
PROPOSEDZ IMPROVEMENT
Address: 3620 ELEVEN MILE ROAD; FORT PIERCE, FL 34945
Legal Description:
Property Tax ID #: 2328-432-0002-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side::, Left Side:
DETAILED DESCRIPTION
INSTALLING 1 - 1.5 TON LENNOX A/C SYSTEM (16 SEER, 5KW)-WITH DUCT WORK.
el-M-124, 6(t], bq 016V - weroe,
Li Electric El Plumbing - OSpi
Total Sq. Ft of Construction:
Cost of Construction: $ R;
LJ Shutters
Generator
Windows/Doors
Roof Roof pitch
S . Ft. of First Floor:
�'L': Utilities: Sewer Septic - Building Height:
OWNWLESSEE ' F` s
_. z
CONTRACTOR 4.:. -
NameMARKKANE
Name: PHILIPNISAJR
Address:3620 ELEVEN MILE ROAD
Company: NISAIR AIR CONDITIONING
City: FORT PIERCE State: FL
Address: FORT PIERCE
Zip Code: 34945 Fax:
City: FORT PIERCE State: FL
Phone No. 772-240-1867
Zip Code: 34982 Fax:
E-Mail:
Phone No. 772466-8115
Fill in fee simple Title Holder on next page ( if different
E-Mail: KRISTIN@NISAIR.COM
from the Owner listed above)
State or County License: CAC041199
Iit value or construction is $z5uu or more, a RECORDED Notice of Commencement is required. I
SUPPLEMENTALCONSTRUCTION LIfN LAW INFORIUTATION
NGINEER: —,Not Applicable
Name' MARK KANE
Address: 3620 ELEVEN MILE ROAD, FORT PIERCE, FL 34945
City: FORTPIERCE State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address' FORT PIERCE
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby n
I certify that no work or installation has commenced prior to the
St. Lucie County makes no representation that is granting a perm
which is in conflict with any applicable Home Owners Association
structure. Please consult with your Home Owners Association ani
!MORTGAGE COMPANY: _ Not Applicable
Name: PHILIP NISA JR
'Address: 3620 ELEVEN MILE ROAD
City: FORT PIERCE State:
Zip: _ Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
to obtain a permit to do the work and installation as indicated.
Ince of a permit.
I authorize the permit holder to build the subject structure
s, bylaws or and covenants that may restrict or prohibit such
iew 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 WNER: Your failure to Record a Notice of. Commencement may result in your paying twice for
improvement o your property. A Notice of Commencement must be recorded and posted on the jobsite
before the firs spection. If you intend to obtain financing, cons t with lender or an attorney before
commencing k or recording vour Notice of Commencement.
Signature o tner a see/Contractor as Agent for Owner
Signatu of Co tr ctor/License Holder
STATE OFRIDA
STATE F FLORIDA
COUNTY OF sTw--
COUN OF
The forgoing instrument was acknowledgegLbefore me
The forgoing instrument was acknowledged efore me
this 24TH day of MAY . 20by
i this 24TH day of MAY . 20JYby
PHILIP NISA JR
PHILIP NISA JR
Name of person making statement
Name of person making statement
Personally Known xx OR Produced Identification
Personally Known xx OR Produced Identification
Type of Identification
Type of Identification
Produc d
Produced
Notary Public
( g ature of Notary Public-
nature of -
�;�:. TIIN BACfSH4
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`rL KRtSTIId BAlTSHQ .
Commission No: FF201465 c•: .r e@ ypE$,SIQ�t.�FF2Q,,
mission No. FF201485
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4o7) 39"163 DkilduN UVICO WTI '.
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(407) 396-0153 FlofidrNomrySIIPv1¢a Wm
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17