HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi�
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 6ZZ�
/�
Date:Yr I , Permit Number: -
Rkdoil Q
F
Building Permit Application cie
Planning and Development Services Uh�Y
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
PRQPOSED [M.,P'ROVEMENT LOCATION:
Aririres.s- 9212 Short Chip Cir
Legal Description: LAKES AT PGA VILLAGE
Property Tax ID #: 3334-501-0211-000-5
Site Plan Name: 9212 Short Chip Cir
Prniert Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION`�O'F WORK:
AC CHANGE OUT 5TONS 15HEAT PUMP 10KWS
CONSTRUCTfON�,I N FORMATION:
Lot No._
Block No.
Additional wor to jeperformed under
❑✓Gas Tank
this permit— check
❑Gas Piping
a apply:
Shutters
a Windows/Doors
HVAC L—J
_
—
0 Electric 0 Plumbing
Sprinklers
0 Generator
Roof
Total Sq. Ft of Construction:
4760.00
S Ft. of First Floor:
0
Building Height:
Cost of Construction: $
Utilities:cn
Sewer Septic
OVVN.ER/.LESSEE:," ..'CONTRACTOR:
"
Name Claude Bedard Louise Drolet
Name: RICHARD LEVINSON
Address: 9212 Short Chip Cir
Company: SERVICE AMERICA
City: Port St Lucie State: FL
Address: 2755 NW 63RD COURT
Zip Code: 34986 Fax:
Phone No. 772-828-9455
City: FORT LAUDERDALE State: FL
Zip Code: 33309 Fax: 954-977-3591
E-Mail:
Fill in fee simple Title Holder on next page ( if different
Phone No. 954-979-1100 EXT 5673
E-Mail: EPERMITSGROUP@SERVICEAMERICA.COM
State or County License: CAC014619
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice oT c:ommencement is requires.
J
SUPPLEfVIENTAL'CONSTRUCTION LIEN LAW INFORMATION ;
..
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ 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:
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 the jobsite
before the first inspegction. If you intend to obtain financing, consult with le der or an attorney before
commencing work o1k recording your Notice of Commencement. T
STATE OF FLORIDA
COUNTY OF PALM BEACH
The forgoing, instrument was acknowledged before me
this day of , 20 14 by
RICHARD LEVINSON
(Name of person acknowl
0 . ,-wig �
(nally Kown I /fR Produced Identification
of Ide tificationoded
STATE OF FLORIDA
COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me
this 15 day of 9 , 2014 by
RICHARD LEVINSON
(Name of person a
of NoNry Ou4Tic- State of Florida )
bnally Known l !// OR Produced Identification
of Identification Produced
on No. *:� "•}�6, CJESSICA
OMMIS
S072984 Commission No.
=�•. :�: EXPIRES: November 25, 2017
Revised 07/15/201
JESSICA DOMRI )
MY COMMISSION 8 FF 072984
EXPIRES: November 25, 2017
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS