HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED-FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1 5()5-o,315
RECEIVED MAY 2 72o
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2.300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 cor1' merCial Residential x
PERMIT APPLICATION FOR, Mechanical v q C
Address:
Legal Description:
Property Tax ID#: 1 X11 .fir '" ,�- . . Lot No.
Site Plan Name: Block No.
Project Narne
Setbacks Front Back: Right Side: Left Side:
LIKE"FOR LIKE=AIC CHANGEOUT-NO DUCT WORK Z
tt ona wor to e e Orme under t s permit—C eC a app y:-
R✓HVAC E]Gas Tank Gas Piping Shutters L,Windows/Doors
CElectric Plumbing Sprinklers a Generator Roof
Total Sq. Ft of Constructio�n:y � So. Ft.of First Floor':
Cost of Construction:$, 4:1 ,. L Utilities: $ewer�Septic Building Height:
1122 1111=3
Name �' Name: JAMES UErGsATINA
Address: company: ALL AMERICAN AIR&ELECTRIC, INC
City: Address: 611 NW MERCANTILE PL
Zip Code: Fax: City: PORT ST LUCIE State:FL
Phone No. ng�a- Zip Code: 34886 Fax: 772-878-5144
E-Mail: Phone No. 772-878-5143
Fill in fee simple Title Holder on next page(if different E-Mail:.. j:T _ ', (•t4 ,�C it�1C, �a{i1
from the Owner listed above) State or County License: CAC057965
If value of construction Is$2500 or more,a REC61RDED Notice of CoinmenCgm0t is required,
DESIGNI�i�/FNG1NfER: x Not Appliea a i►gp# NAGE COMPANY: x Not Applicable
Name: _-- Name:
Address:
Address:
city:_ St City., State'
Zip: T phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER., x t Applicable BONDING COMPANY• X Not Applicable
Name: Neale:
Address: Address,
City: city:
Zip: Phone, Phone'
OWNER/CONTRACTOR ApFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the Issuence of a permit.
St.Lucie Coun makes no representation that Is granting a ,ermit will authorize the ermit holder to build the subject%kiicture�
which Is in convict with any applicable Houle Owners Association rules,bylaws or anfcovenants that may restrict or pro i it such
structure.please consvit with your Home Owners Assoclatlon and review your deed or any restrictions which mpy apply.
In consideration of the granting of this requested perrnit,I do hereby agree that i will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from onclergoing a full concurrency review;room additions,
accessory structures,$wimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Nctitice of Commencement may result in your payingtwice 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 lender or an attorney before
commencin work or recording our Notice of Commencement.
Slgnat ner/Agent/Lessee Si ctor/tsceriseHolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF 67LU0I9
The.for ping instrument was acknowled ed before me The far sing instr ent was acknowledged before me
this 2,„2day of 20�by this day of zOC�by
JAMES DEGAMNA JAMES DEOATINA
(Name of person acknowledging) (Name of person acknowledging)
1gnAture of Notary Public-State of Florida gnature of Notary Pub is-State of Florida)
Personalty Known x..._—_OR Produced Identification Personally Known x OR Produced identification T
Type of Identification Produced Type of Identification Produced
mmission No. EE 105900 (Seal)
Commission No. X10 I L.CALHOUN •
Notpry public-State of Florida ,.••��!����., GERI L.CAi.HOUN
,�. Notary I'Alln-State p Florida
Revised 07/15/20 Commission# �105900 _•; ,'�•_ My Comm.Expires Oct 6,2015
��' 4%�� '� Banded Through National Notary 9 a y Assn. Commission sN EE 105900
JR Main.REVIEWS FRONT ZONING SUPERVISOR PLANS VEC,I=TA' A U Tl. U1A 0 E
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