HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAS E INFO M BE COMPLETED FOR APPLICATION TO 66 ACCEPTED I `C_ _ ��
Date: �� Permit Number, ']T`�,�
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: 906 JACKSON WAY
Legal Description:
Property Tax ID#. 1423-802-0015-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side, Left Side-
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LIKE FOR LIKE 16 SEER 4 TON 10 KW A/C CHANGEOUT
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lona work to orme 'under this permit—check a appy:
ZH 'AC ,Gas Tank E]Gas Piping _Shutters Windows/Doors
11ElIctric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of gonstruction:$ 6236.00 Utllities: Sewer 11 Septic Building Height-
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Name QI ROYLN POLLARD Name: JOHN V LANGEL
Address Company; SEACOAST A/C
City: FART PIERCE State:FL Address: 2601 INDUSTRIAL AVE 3
Zip Code: 34949 Fax: City: FORT PIERCE State:FL
Phone No.772-801-5866 _ _ zip Code: 34946 Fax: 466-3053
E-Mail: Phone No, 772-466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEACOASTAIR@AOL.COM
from the Owner listed above) State or County License: CAC016446
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State;- City, State;
7-1p: 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.
Lucie.coug makes no representation that is granting a permit will authorize the permit holder to build the subject structure
11�ich is in conflict with any applicable Home Owners Association rules,bylaws covenants that May restrict or prohibit such
I law
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,W8115,signs,screen rooms and accessory uses to another non-residentlal use
WARNING TO OW :Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to yo"property.A Notice of Commencement must be record and posted on the jobsite
before the first inspi0ion. If you intend to obtain financing,consult with Ienj1r or an 1t±07 ev before
commencing work Mricording Vbur,,Notge of Commencement. 7 ?7
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Signature of 11" erl Lessee/Ag t Signature of Contor/License older
STATE OFF RIDA STATE CIF F IDA
COUNTY 0jr6'rLuc1r; COUNTYOFsTlucls
The filiigying instru was ack wledge efore me The forgoing instrument was acknowledge rore me
20
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this JCZ*Y of f4l AJ--A 20 this_day of "Ay y
JOHN v LANrrL-,---- JOHN V LANGEL
(Nan acknowi (Name of per ackno Sing)
Signature 9"tary-Fubil of Florida) (Signature of NotaryK2j-State of Florid
Personall K4% Md 96 n
Personail )n
Type of
pjW�a%tLmISSION#Fr148072 I cic q;'P r
Type of id Wf 619AWMISSIQN1#F5148072
EXPIRES August 30,2018 EXPIFIES August 30,2018
C.ommissl�lr� COMMissiop(,N�=pisp parioNotarySery4godA)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLITI
INITIALS
00 39Vd -1V13W 133HS 1SV00V3S Z.TVZ99VZLL LS:LO S10Z/ZT/S0