HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/04/15 a2�, �� Permit Number:
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2401 W,
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� Build ppmk ,Application
Planning and Development Services
Build
ng and Code Regulation Division
23001 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
RRUI?OSED,INiPR`OVEMENT LOCATLON y' ,
Address: 8246 SAND PINE CIR
Legal Description: LAKE LUCIE ESTATES
Property Tax ID#: 3426-703-0028-000-7 Lot No. 14
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WURK:,
y�
A/C CHANGE OUT OF A RUUD 3.5 TON 16 SEER 5 k W
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CONSTRUCTION INFORMATION 4 ra
. __
Additional work-to be nertormpd under tispermit—cleck all appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing []Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 3300 Utilities:n Sewer❑Septic Building Height:
77,77777-7,
OWNER/LESSEE CONTRACTORsz
Name JOSEPH CAOUETTE Name: THOMAS A.SMITH
Address:8246 SAND PINE CIR Company: ALL YEAR COOLING &HEATING
City: SAINT LUCIE State:FL Address: 1345 NE 4TH AVE
Zip Code: 34952 Fax: City: FT. LAUDERALE State:FL
Phone No.561-276-3345 Zip Code: 33304 Fax:
E-Mail: Phone No. 954-745-8805
Fill in fee simple Title Holder on next page (if different E-Mail: DDANIELS@AYCAIR.COM
from the Owner listed above) State or County License: CAC058159
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW 1FRMATION '
�.
. .:
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 mus be recorded an posted on the jobsite
before the first inspection. If you intend to obtain financing, con with lender o attorne before
Com encin work or recordingour Notice of Commenceme t
( 1
V�16ZEU� 4%� s
_Slgature of Owner/Lessee/Agent Signature of Contractor/License Holder
STA E OF FLORIDA STATE OF FLORIDA
COUNTY OF ST I_LICIE COUNTY OF RrnnrARn
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 04 day of MAY 20 15 by this 04 day of MAY ,20 15 by
DIMITRIUS A.DAIELS DIMIT A.DANIELS
(Na L11 erson acknow ledgin ) (Na e o person ac nowledgl
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known Personally Known OR Produced Identification
Type of Identification P �:�. r.�.,�Te���� w nwwre� Q Type of Identification Produced 7-iv •..,
DANIELS •., DIMITRIUS ADA IE'.S r
Commission No. J
MY( MMISSIONFF173128
r/i jII Commission No. �:. (.� aA�Y COMMISSION#F 328
•h, ® , „�` EXPfR99 October 30,2014 •Z dEXPIRES October 3 2018
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Revised 07/15/2014
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