HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: April 27, 2016 Permit Number: is OIN - ns.?9
' SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Mechanical
,,PROPOSED IMPROVEMENT LOCATION: III
Address: 8350 Picos Road, Fort Pierce, FL
Legal Description: Please see attached.
Property Tax ID #: 2314-200-0000-000-4 Lot No.
Site Plan Name: University of Florida Agriculture Extension Office - Fort Pierce, FL Block No.
Project Name: Ag Center chiller change out
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
Change out existing chiller with 40 ton air-cooled chiller
Seperate electric permit (1604-0373) has been issued.
CONSTRucTiON INFORMATION:
Additional work to e e orme under t—checkispermit a
apply:
❑HVAC
E] Gas Tank
❑Gas Piping
_Shutters
❑
Windows/Doors
❑Electric ❑Plumbing
❑Sprinklers
❑Generator
❑Roof
Total Sq. Ft of Construction: NIA
S
Ft. of First Floor:
Cost of Construction: $ 55,000.00
Utilities:llSewer
❑Septic
Building Height:
OWNER/LESSEE: c '
CONTRACTOR:
Name St. Lucie County
Name: OwneriBuilder-St. Lucie County
Address:2300 Virginia Ave
Company:
P Y:
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 462-1444, Facilities Fax
Phone No. 462-1432, Bob Ettswold, Project Manager
Address: 2360 Virginia Ave
City: Fort Pierce State: FL
Zip Cade: 34982 Fax: 462-1444, Facilities Fax
Phone No. 462-1432, Bob Ettswold, Project Manager
E-Mail: ettswoldb@stlucieco.org
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: ettswoldb@stiucieco.org
State or County License: NIA
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: .
DESIGNER/ENGINEER: _ Not Applicable
Name: Trane/Chris Cowling
MORTGAGE COMPANY:
Name: NfA
_ Not Applicable
Address: 6965 Vista Parkway North, suite 11
Address:
City: West Palm Beach State: FL
Zip: 3341 Phone: (561)6a3-1e21
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: NA
BONDING COMPANY:
Name: NIA
Not Applicable
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 andcovenants 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
_ Signature of� Lessee Agent
S
Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF S+. Luc i e COUNTY OF
The forgoing instrument was acknowledged before me
this P*I'L day ofT 20 IL by
The forgoing instrument was acknowledged before me
this _ day of
(Name of person acknowledging) (Name of person acknowledging )
Sig ature of Notary Public- State of rida )
Personally Known Yr9 ii, yn
Type of Identification
Ex piresDecember4,2016
Commission No. maf%lTh. T(5Ba1(SaXaiweaesroly
Revised 07/15/2014
20 by
(Signature of Notary Public -State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
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