HomeMy WebLinkAboutBuilding Permit Application From:CMI - LAKE PARK FLORIDA 05/08/2015 12:29 #858 P.001/008
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: MAY 8,2015 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 X
PERMIT APPLICATION FOR: Mechanical
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Address: 12198 RIVERBEND LANE PORT ST.LUCIE
Legal Description: BAY ST.LUCIE
Property Tax ID#: 4422-502-0025-0000 Lot No.22
Site Plan Name: S.KENT ROCKWELL Block No.
Project Name: S.KENT ROCKWELL(TR)ROCKWELL VENTURE CAPITAL 960 PENN AVE STE 400 PITTSBURGH,PA 15222
Setbacks Front Back: Right Side: Left Side:
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LIKE FOR LIKE A/C CHANGE OUT 3 TON 14.5 SEER 10 KW
MINOR`
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1ZHVAC IJ Gas Tank Das Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing QSprinklers Generator Roof
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 3,540.00 Utilities: Sewer ElSeptic Building Height:
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Name Name: JAMES PICKARD
Address: �"� � Company: CMI AIR CONDITIONING&ELECTRCIAL INC.
City: State: Address: 202 OLD DIXIE HWY
Zip Code: Fax: City: LAKE PARK State:FL
Phone No. Zip Code: 33403 Fax: 561-844-1074
E-Mail: Phone No. 561-8441004
Fill in fee simple Title Holder on next page(if different E-Mail: STEVE@CMIAC.COM
from the Owner listed above) State or County License: CAC1817971
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
From:CMI - LAKE PARK FLORIDA 05/08/2015 12:30 #858 P.002/008
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicablet
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 thepermit 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 with I er or an attorne before
commencing work Wecordin o tice of Commencement.
:K s
_Sig re f Owner/Lessee/Agent gnat of Contractor/License Holder
ATE OF LORIDA STATE OF LORIDA
COU OFPALMBEACH UN FPALMBEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this X day of ��- 20 /� by this 8 day of mAY 20 Zj�:by
67 f�Cc`t�2 k 7.�.rZ r-.t f'rchyic c�
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Nota lic-State of Florida) (Signature of No Public-State of Florida)
Personally Known *>r— OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Pro JUN"" ype of Identification Pro
E A BA DAftLE A BARCINE
Commission No. -_ , ;�€ MY($QqMISSION#FF09950Commission No. r
EXPIRES March 9,201 mt ,oma= MY COMMISSION#FF099$49
Or M,,• EXPIRES March 9 2018
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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