HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �r p� l (f
Date: SCANNED Permit Number: V `btIO
St. Lucie County ✓UN
Building Permit Application pen++, 1 1018
Planning and Development Services W 8 aQOantm
Building and Code Regulation Division No Cavoeqt
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Electrical
Address: 10l Al. f2oLk F OAa( !"orb f�+e.rc2 T4_
Legal Description: St. Lucie County IT Bunker
Property Tax ID #: 2311-210-0000-000-6
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
Replace two 40 ton air-cooled chillers with like 40 ton air cooled chillers. Re-route chilled water pipe for
both chillers and re -insulate pipe disconnect controls reconnect.. For Electrical work see attached
description of sub -contractor.
ZHVAC
11 Electric
0 Plumbing
❑ Windows/Doors
ElRoof
Total Sq. Ft of Construction: � S❑I Ft. of First Floor:
Cost of Construction: $ —lQutilities: Sewer Eheptic Building Height:
OWNER/LESSEE; „. -
CONTRACTOR:
Name 5-L. 44"A
Name:
Address: 1$0o Vrr4 r+in. AUP—
Company: St. Lucie County
City: Fo rt R, r LC State: FL
Zip Code: 3 4 4IF2. Fax:
Phone No. i 7 '1 - 4 61 -+ t o o
Address: -A S o o V I f G ^t ;A. AO e
City: Folk _1�4 erc�Z_ State: FL
Zip Code: '! a 4 8 2 Fax:
Phone No. 77 �- 46 X I/ o O
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEME1VTALCONSTRUCTIOIIEN LAW INFORMATf13N * '
:a. a..3 x't. r,a4t.. .. ..r ...
A .s....i 4ni. ....£:�
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
4—Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
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 County 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
improvements to your property. A Notice of Commencement must be recorded and posted on thejobsite
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.
Signaturgf of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORI
STATE OF FLORIDA
COUNTY OF S Cye_
COUNTY OF
The forgoing instrumprit was acknowledged before me
The forgoing instrument was acknowledged before me
this 13 day of n e 20 /9 by
this _ day of . 20_ by
,I bosd;K)
_�remlah
Name of person making statement
Name of person making statement
Personally Known ✓ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
- rEC
(Signat re of Notary blir,- fgtel,.Ig[f$S��i80ECKEL
(Signature of Notary Public -State of Florida I
''TsCommissiongFf979475
Commission No. - °�` xpiresA{Wq?1b20
Commission No. (Seal)
B onded Thm Troy Fain lnsumm888.888.1818
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
J Q
7J
COMPLETED
G
Rev.8/2/17