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HomeMy WebLinkAboutSUBMITTED PAPERSJan 06 15 10:59a Dodd Enterprises Inc. 772-335-3310 p.2 ALL APPLICABLE INFO MUST BE COMPLETkO FOR APPLICATION TO BE ACCEPTED Date: 1/5/2015 SCANNED Permit Number: /"�-o By St. Lucie County Building Permit Application Planniny and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentia I X PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVEMENT Q)CATION: Address: 758 Nettles Blvd Legal Description: Parcel IDA 4502-501-094A-006-0 Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Lot No. — Block No. I DETAILED DESCRIPTION OF WORK: i Change out 3 ton 15 seer Frigidiaire st cool pkg unit 8 kw heater like for like CONSTRUCTION INFORMATION: I Additional work to be nertormed under this permit— check Ehas all apply: L FIVAC Tank 7Gas Piping Shutters Windows/Doors []Electric 0 Plumbing OSprinklers Generator Roof Total Sq. Ft of Cc nstruction, 300D.00 5 . Ft. f First Floor: E]Septic Cost of Construction: $ Utilities:11 Sewer Building Height: OWNER/LESSEE: CONTRACTOR: Name John Johnson Name: Vance R Corbin Address: 758 Nettles Blvd Company: Dodd Enterprises Inc city: Jensen Beach State: FI Zip Code: 34957 Fax: Phone No. 772-229-1623 Address: 1296 SE industrial Blvd City: Port St Lucie State: FI Zip Code: 34952 Fax: 335-3310 Phone No. 398-2344 E-Mail: Fill in fee simple Title Holder an next page ( if different from the owner listed above) E-Mail: doddenterprises@dodd.cc)m State or County License: CMC1249958 if value of construction is $2500 or more, a RECORDED Notice of ornmencement is required. Jan 06 15 10:59a Dodd Enterprises Inc. 772-336-3310 p.3 i- SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I DESIGNER/ENGI NEER: x NotApplicable Name: MORTGAGE COMPANY: x NotApplicable Name: Address: Address: City: State: _ Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TIT LE HOLDER: x NotApplicable Name: BONDING COMPANY: x NotApplicable Name: 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 �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 rule�, 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 inn provements to you r property. A Notice of Commencement must be recorded an d posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencin-e work or recordina vour NotIce, of Commencement. 4 C-LX / W k AnfL&d Sio6ature- of Own er/ Agent/ Lessee SilTnature"of Contractor/License Holder STATE OF FLORIDAnd STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrLiment was acknowledeedbefore me The fo�gpiing instruyent was acknowledudPefore me this "J_ day of this 'S day of LA&Aj4 202)�L by (Name of person acknowledging) (Name of person acknowledging) (Signature of Not4o Public- State of Florida Personally Known —OR Prod u�,ced�n _f7 Type of.I,derWfffdJq,?n Pro) uce —LJI= SU -_AY COMMISSIO eF 017 :-I— to' '�D(PIFIES December 12.2 at *--P�uz iSignature of Kota Pub[ . c- State of Florida Personally Known e den ication L - � yg�i rLpr qC Type of n r. MY or 12, �%Va. e%P1Fkk:.S ---------------- - REW __4:9GNT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE IVIAXC��,�nt7E. -OUNTER C REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIAI S Jan 06 15 10:69a Dodd Enterprises Inc. 772-335-3310 P.1 BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE ORT PIERCE, FL 34982 WIM'Fi'771"� 772-462-1553 FAX 772-462-1578 AUTHORIZATION FORM FOR CREDIT CARD PAYMENT TO: St Lucie County RE: Permit # Credit Card Users., 1.5% Surcharge addedper trai7sacVO17. Payments, must be received in this department by 4:00 PM for transaction to be processed that day, if not it will be processed the following business day. We -'VISA MASTERCARD Credit Card Number qa6�, 13�j OB-7 96S-�- Expiration Date I =1 Z!pCode 3 digit security codq - Amount $ FAAW, 4��— + 1.50/a surcharge Business Name: r j'5e-S ---EA Authorized Signature: r PrintNarne: vo'xce- r.— Corki'A Phone: GiL) 359- - ;IL3L/1� Fax: (2:15- ) '33 5- -3� 1 Comments: se- -f�y, �Yck wiiAII%+ /,�n I. , L9 SLCPDSD Revised 410112010 EN