HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE-COMPLETED FOR APPLICATION TO BE ACCEPTED Sr I
Date: _ Permit Number:
•
Building Permit Application
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
PERMIT APPLICATION FOR: Mechanical
PROPOSED INPR NEMEI9T LOCATION
Address: I CA (�qGi116
Legal Description:--12�Je It QW � -81 in k -j
Property Tax ID#: —(�r7( � O 5� cx) OOO Lot No. .
Site Plan Name: el Block No. Jr--
Project Name: t O6j kn0-tom
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION O'F WORK..,,,:.,-
14
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CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a Trial appy:
6HVAC f]Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing ❑Sprinklers Generator Roof
Total Sq.Ft of Constructio�n:t lDta� Sq. Ft.of First Floor:
Cost of Construction:$ —t" fin•C7 Utilities:l Sewer Eleptic Building Height:
OWNER/LESSEE CONTRACTOR
RALPH
Name t n C lU Name: WARREN
Address:' .10 1 Ax, 4 ZL t" Company: AIRFLOW A/C AND HEATING
City: State:FL Address: 50 NE DIXIE HWY SUITE D-1
Zip Code: q a Fax: NIA City: STUART State:FL
Phone No. '`1922) �, 9 r 554L� Zip Code: 34994 Fax:
E-Mail: � Phone No. 772-781-2665
Fill in fee simple Title Holder on next page(if different E-Mail: airflowacfl@gmail.com
from the Owner listed above) State or County License: CAC1817930
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAI.GC}NSTREICT!{?N LiE{ l AVt4lNCtRMAT!{�N
DESIGNER/ENGINEER. Not Applicable MORTGA.GE.COMPANY: Not Applicable
Name: _ Name: a
Address: Address:
City: State: City: State:. I ``
Zip: Phone:- _ Zip: Phone: s
FEE SIMPLE TITLE HOLDER. Not Applicable BONDING COMPANY: �Not Applicable ,.
Name: Name:
Address: Address:
City: _ City: ;
Zip: Phone: Zip: Phone
s".
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 Count makes no representation that is granting a permit.will authorize the permit holder,to build the subject structure l
vihnch h in conflict with any applicable Home Owners Association rules,bylaws or ant]covenants that may restrict or prohibit such.
,it ructrrre: Please c,6nsuit avith your Hyrne.0wners As!:eciation and review your deed for any restrictions which may appty.
in consideration,of the granting of this requested'Perini t,i do hereby agree that I will,in alt respects,perform the work
in=accardance with the approved plans,the Florida Building Codes and St.Lurie County Amendments,
The fol lowtng buiiding permit appiication s'are exempt from undergoing a full concurrency review:room.additions,
accesso y structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residentla€u:-:e
WARNING TO OWNER:Your failure to Record a Notice of Commencement:may-result inyour paying twice for
improvements to your property, A Notice of Commencement must be recorded and posted on the;obsite 41
before the first inspection. If you intend to obtain financing,consult with lender or,an attorney before ckl
commencing work or rerdinyour Notice of CommencermRe
Sig ature of Oti rJ Aj;entj Lessee i 5ignkur¢e o.` ntrartor License 1-folder
STATE OF FL RIDA STATE OF FLORIDA
COUNTY QFCwt C ''� COUNTY OF `�" aL't` �
Tile for, to•rtg instrument acknowledged before me i The for ng instru ent wa acknowledged before me t;
thi av of,�' 201M by t}ii�ay of _ 2t)�by r
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(Manse of person acknowledging) � (Name-of person acknnwtedging} � ;✓
I (Signature of Notary Public-State of Florida} i i5rgr�ature of Notary Public-State of Florida}
Personally Known V// OR Produced tdenit ticabcis _ _T Personally Known —OR Produced.tdentification 1
( Type of Identification:Pro utAd _, _ ! pe of Identification Prndur.Pd
J`SARY 1,`A i DE80RAH RUSS' L
EBORAH RUSSELL �M ?r°. «`a;�a�otary Public-State o iFtort'a
a ion .elision No.sr(rrimissuarr Pjrs-_..� -.'a�+ •`'rE - •
t Public-State of Ft nda « :Q y Comm.Expires Noy' �Q,2018
'•: ;•5 My Comm.Expires Nov 30,2018 r ��' Commissia se
'. �.. Ff 1- 6X'
q `—Caltiitfissii5h FF"t7963D"_ -` ,��»�•,
Bonded through National Notary Assn. Banded through National No ry assn.
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REVIEWS � FRONT s ZONING SUPERVISOR PLANS � VEGETATION SEA T'LIRTLE MANGROVE � 1.
COUNTER REVIEW � REVIEW REVIEW I REVIEW REVIEW REVIEW
DATE ( I I
` RECEWED
DATE _ t
CGl41PLETED. i ' �-
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