HomeMy WebLinkAboutBuilding Permit Application J �
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: �7 �K Permit Number:
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Building Permit Application e .,�s - f2
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 Residential x
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 13515 S INDIAN RIVER DR 706
Legal Description: INDIAN RIVER LANDING
Property Tax ID#: 4509-804-0046-000-6 Lot No.
Site Plan Name: Francine S Kelly John Kelly Block No.
Project Name: Francine S Kelly John Kelly
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC CHANGE OUT 2TONS 15SEERS 5KW
CONSTRUCTION INFORMATION:
Additional work toe nertormed under this permit—check a appy:
HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
FlElectric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 3475.00 Utilities:'nSewer E]Se . ' n�'�1 "ef ht:
OWNER/LESSEE: � CONTRACTOR: WIR I �fl1
Name Francine S Kelly John Kelly Name: RICHARD LEVINSON .rtIOG
13515 S INDIAN RIVER DR 706 SERVICE AMER C ounty'
Address: Company: ��e C
City: JENSEN BEACH State:FL Address: 2755 NW 63RD COURT
Zip Code: 34957 Fax: City: FORT LAUDERDALE State:FL
Phone No.609-828-3170 . Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100 EXT 5673
Fill in fee simple Title Holder on next page(if different E-Mail: epermitsgroup@serviceamerica.com
from the Owner listed above) State or County License: cac014619
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL 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 inspection. If you intend to obtain financing, consult ith lender or an attorney before
commen ork or recordingour Notice of Commencement.
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_Sig at re-of Owner.%Lessee/Agent-- 4 Sig a�e,of Contractor./License•Holder,•
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sainllucie COUNTY OF saint lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 _by this 23 day of 4 20 _by
richard levinson richard levinson
(Name of person J",oled ing) (Name of pers n 'tkno edging)
(Signature 6 ota 'Pub Ic- tate of Florida) (Signa ure o N r ic-State of Florida)
Personal,14nowr '' OR Produced Identification Per nally K wn X OR Produced Identification
,�� r �°
Type of/dentificai ` n Produced f Type of Ide t ication Produced
// JESSICA pOT50N JESSICA DOTSON
Cam" mission No. ,•;sY ev SII F072984 '°`���Y�c'= OMMISSION �b
COMMIS�1�61 Commission No. :_.
__• W; 2017 = EXPIRES:November 25,2017
EXPIRES:November 25, Hers
ES Notary Publ'a Underar ` •••��F•' Bonded Thru Notary Public undewdters
Revised 07/15/2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION A %E�A' 'TURTLE MANGROVE
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