HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONl
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: I db3 - 1. SdS
SCANNED
BY
St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x
RECEIVED
MAR 19 201E
permitting Department
St. Lucie County
Residential
PERMIT APPLICATION FOR: Mechanical El III
ED IMPROVEMENT
Address: 32/1-1 Aventle D. Pierre C1, ?//I'/7
Legal Description: (not available on property appraiserwebsite)
Property Tax ID #: 2408-211-0001-00013
Site Plan Name:
Project Name: Family Dollar Store
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
'DETAILED DESCRIPTION OF WORK: III
Install (6) customer supplied reach -in refrigeration cases. 100% self contained. No plumbing.
No exterior components.
CONSTRUCTION INFORMATION:
onai worKto oe errormeu unaermis perms-cnecr au apply: 7i6F.Br66XAT70,V
HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator 0 Roof = Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 4�u[%
9. �i� . �0• Utilities. Sewer 0 Septic Building Height:
OWNER/LESSEE.
CONTRACTOR:
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-Name: Sfevin /61. A/JWRr'
—
Address:
�%999 Al. F
E/.iP.r[Ll I�wG
Company: Southern Air Mechanical Services, LLC
City: 1 OG4, AltOh State: FL
Zip Code: 33487 Fax:
Phone No.
Address: '7519 J'C 51Q% 444d _4
City: Len%n State: FL
Zip Code: 32693 Fax: 352-354-3502
Phone No. 352-472-4001
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: admin@samshvac.net
State or County License: CAC050395
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: ✓ Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 Count makes no representation that is granting a permit 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 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
impro ments to your property. A Notice of Commencement must be recorded and posted on the jobsite
befo a he first inspection. If you intend to obtain financing, corysult with lender or an attorney before
com cing ork or recording your Notice of Commencement. li n/1 . I
I
A
AL
I L�
of O n Lessee C ntractor as Agent for Owner
=TATE
Signa r of ontractor icense Holder -
F FLORIDA
STATE OF FLORIDA
COUNTY OF Grlchri,r
COUNTY OF ailgArisl
The for oing instrument was acknowledged before me
eday
The forgoing instrument was acknowledged before me
this of AMAO, 20JI by
this &LP day of &9rf h 20_LZ by
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J91I°✓°n 41' a'lror
Name of person making statement
Name of person making statement
Personally Known ✓ OR Produced Identification
Personally Known" L/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Publi
Sfa of Fjorida
(ignature of otary Pub t?s5t 6f1FIM!tbJMMISSI0N #FF18087
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•' MY COMMISSION #FF180
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itMM111 sI011 No. 153 FlifritTLT,otaryseMce.com
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CommI5510n No: '�F"'-"o ::' E($natkS December 6, 20
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(407) 398-0M FloridallotarySemm.mm
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Rev.8/2/17