HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/26/2018 SCANNED Permit Number:
BY
St. Lude County
Building Permit Application
NOV 0 8 2018
Building and Code Regulation Division
Planning and Development Services
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Resid ial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line HVAC UNIT
PROPOSED IMPROVEMENT LOCATION:
Address: 7115 S US HIGHWAY 1
Legal Description: SEE ATTACHED
Property Tax ID#: 3422-211-0010-000-6
Site Plan Name:
Project Name: LUX ARCADE
Setbacks Front Back:
DETAILED bEkRIPTIO,N'OF WORK:
Right Side: Left Side:
Lot No.
Block No.
REPLACEMENT OF 4TON 3 PHASE UNIT WITH CRANE & CURB ADAPTER
Vw 14 lee—(z Cocke OwQ_41i-q�672�-
1CONSTR . UCTION INFORMATION: -
Additional
2HVAC
kt b rt d under
1:1 Gas Tank
this permit --check
E]Gas Pipi
all
apply:
Mutters L]Windows/Doors
_
[]Electric
E] Plumbing
OSprinklers
1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: —
5600-00
S
Ft of First Floor:
Cost of Construction:
$
Utilities..
SevverE]Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name PORT ST LUCIE PLAZA I LILG
Name: HI -Tech Plumbing &Air
Address: 112 PHYLIS CT
Company: ABIEL
City: ELMONT State:NY
Zip Code: 11003 Fax:
Phone No.
Address: 1000 Stinson Way #111
City: West Palm Beach FI 33411 State: —
Zip Code: Fax:
Phone No. 561-790-6966
E-Mail:
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail: SERVICE@HI-TECHPLUMBINGANDAIR.COM
State or County License: cacl 817688
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW, INFORMATION,: -
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY: —Not
Name:
Applicable
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 Coun% makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con, lict with any applicable Home Owners Association rules, bylaws or and covenants that m"Mi estrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions w ch 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
commencioR work or recordiniz vour Notice of Commencement. /
u 1�wner/ Lessee/tontractor as Agent for Owner
Sfnat6re of Contractor/License Hol(Ter
rE OF FLOR
;�
F-V
STATE OF FLOM2 8-
INTY OF M
"
COUNTY OF
The for g instrumerli WP5 acknowledged before me
1 Vby
The forgo . ng instrument was/acknow,ledged before me
194ray of Od 0
t0*X_4__ 2
this ayof 2ilk by
Name of perso5x6aking statement
Name of person k
,pa ing statement
Personally Known JZ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identificat--k-1-1,_
10
PrcAuced
Produced
(fignature of Notary I - - - -
nature of Notary�Publi �_Ldj�W.yj Fluricia
(I P", &MARA MARCELO
XIOMARA MARCELO
Notary Public - State of Florida
Commission No. Notary 0WRI4 State of Florida
Commission No. d&ara4ion is GG 182049
Commission A GG 182049
My Comm. Expires Feb 17,2022
My Comm. Expires Feb 17,2022
nded through National Notary Assn.
Bonded thromb National Notary Assn.
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RECEIVED
Rev. 8/2/17