HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONJ
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j I q
Date: April 19, 2017 Permit Number: l� �(�(1J ,4 - O A � I
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Building Permit Application SCBY
Planning and Development Services St,
Building and Code Regulation Division St Lucie County
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:
Address: 1306 Avenue M, Fort Pierce, FL. 34950
Legal Description: Please see attached.
Property Tax ID #: 2404-516-0001-150-3
Site Plan Name: Lincoln Park Community Center
Project Name: _Lincoln Park Community Center HVAC improvements
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
In exercise room replace HVAC package unit with 5 ton split system.
In game room install new 5 ton split system.
CONSTRUCTION INFORMATION: Ill
LJHVAC LJ Gas Tank UGas Piping LJ Shutters
Electric Plumbing Sprinklers 11 Generator
Total Sq. Ft of Construction: 1184 sf & 960sf= 1,280sf S Ft. of First Floor: _
Cost of Construction: $ $16,000.00 Utilities: Sewer Septic
QWindows/Doors
0 Roof = Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name St. Lucie County, FL
Name: Owner/Builder - St. Lucie County
Address: 2300 Virginia Ave
Company:
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772-462-1444 (Facilities)
Phone No.462-1432, Bob Ettswold, Project Manager
Address: 2300 Virginia Ave
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 7724162-1444 (Facilities)
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@stlucieco.org
State or County License:
ir vame or construction is yzsuu or more, a RECORDED Notice of Commencement is required.
-7
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
x
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
Zip: _
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: x Not Applicable
Name: _
Address:
City:
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 df Owner/Less/Contractor as Agent for Owner
STATE OF FLORIDA LUG I
COUNTY OF S T
s
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The for o.ng instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ayof A PK14 . 20 -by this day .20 by
DGhfeIfc13i,9liv1
(Name //ofperson acknowledging ) (Name of person acknowledging)
/./fp�wnt�& jj
(Signature of Notary Public- Staid of Florida) (Signature of Notary Public -State of Florida )
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Personally Known v OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. r l O99
Revised 07/15/2014
Danlelle I Iln
Commission 9sion No:
Expires: Au91 25.2019
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS