HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Da 1 I cI 1 Permit Number:
RECEIVED
Building Permit Application J4 0 4 Z019
Planning and Development Services
Building and Code Regulation Division ST. Lucie Count Pert111EtIFl�
Y.._
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPQSS�QD1;jMROVEIVIENT
Address:`�QC'
Legal Description: We< ' k V-4 a
Property Tax IDq:('jIty.` m-V)0)nz)-t1Y/ b--1 Ljt'% (,8
Site Plan Name: ln� ` Block No.
Project Name��
Setbacks Front Back: Right Side: Left Side: O
DETAILED DESCRIPTION, OF WORK;
Replace AC, exact change out with aa—ton,1(SEER, KW AC unit,
CONSTRUCTION INFORMATION:
ACClitional work to e e orme under t—checkispermit a apply:
E1HVAC- LiGasTank ❑Gas Piping 1-1 _Shutters
11 Electric 0 Plumbing Sprinklers D Generator
Total Sq. Ft of Construction::
Cost of Construction: $ 111 Oa�l.24'--
S Ft. of First Floor: _
Utilities:] Sewer 0 Septic
Windows/Doors
11 Roof = Roof pitch
Building Height:
OWNER/LESSEE ' -
CONTRACTOR
Named h f\ A•Ftk�Q,<_
Name DennisZacek
Address:Z\C hO Ak I C)
Company: ARS American Residential Services
City ck. �_,c.'e State:ELL•
Zip Code: b4q5a Fax:
Phone No _—� �f� I�
Address: 2800 US Hwy 1
City: Vero Beach State: FL
Zip Code: 32960 Fax:
Phone No. 772 794-72(ba
E-Mail: — '
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: CSU��ryGC� Q CS • �M
State or County License: CMC1249753
n vame or consirucnon is >couu or more, a KMILIKDeD Notice of Commencement is required.
SUPPLEMENTAL CON STRUCTION;;LfEN IAW INFORMATION rh
DESIGNER/ENGINEER:
x Not Applicable
MORTGAGE COMPANY:
x_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
x Not Applicable
BONDING COMPANY:
x Not Applicable
Name:
Name:
Address: !
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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 0 er/ Lessee/Agentr,f Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF Si Lude
The for oing ins ment was acknowledged before me
thisadayof 1i 2,t 20&by
Dennis Zack
( me of person ckn ledging )
ignature of N Pub is -State of Florida )
STATE OF FLORIDA
COUNTY OF Si Lude
The forgoing instr ment was acknowledged before me
this.. day of 10-2r 20 k by
Personally Known X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) (Seal) Commission No. L^�a0�1FJ?1� (Seal)
Revised 0711 J • MY COMMISSION 0 GG0715351 Q� '••= MY COMMISSION # GG071535I
'• EEXPIRES February 09, 2021
EXPIRES February 09, 2021
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
MANGROVE
REVIEW
SEA TURTLE
REVIEW
DATE
COMPLETE
INITIALS