HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
s.:
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
PROPOSED IMPROVEMENT LOCATION:
Address: 164 PEPPER LN
Legal Description: BAY TREE LOT 30 (OR 810-865: 1444-2125; 3403-2513: 3742-428)
Property Tax ID#: 4511-503-0036-000-6 Lot No.30
Site Plan Name: Vaglio Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
A/C CHANEG OUT 3.5TON 16SEER 10KWH
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—c ec a appy:
HVAC Gas Tank Gas Piping _Shutters Windows Doors
❑ a Windows/
Doors
Electric 0 Plumbing Sprinklers E Generator 1-1 Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 4080 Utilities:0 Sewer 0Septic Building Height:
OWN ER/LESSEE: CONTRACTOR.
Name Jacqueline M Vaglio Name: RICHARD LEVINSON
Address: 164 PEPPER LN Company: SERVICE AMERICA
City: JENSEN BEACH State:FL Address: 2755 NW 63rd CT
Zip Code: 34957 Fax- City: Ft. Lauderdale, State:FL
Phone No.772-539-2023 Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100
Fill in fee simple Title Holder on next page(if different E-Mail: EPERMITSGROUP@SERVICEMAERICA.COM
from the Owner listed above) State or County License: CAC014619
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTION LIEN;LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY:y _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 Commence ent may result in your paying twice for
improvements to your property. A Notice of Commenceme must recorded and posted on the jobsite
re re first inspection. If you intend to obtain financin , c n It w h lender or an attorney before
nc work or recordingour Notice of Commence a t.
s
_Sig use of Owner/Lessee%Agent.t gnat Contractor/LlcensHo7de
5�...._,�
STATE OF FLORID STATE OF FLORIDA L
COUNTY OF _t"i'�� L_E,L ` COUNTY OF _5&LjnT Lctc' G
The f oing instrumentPwas acknowledged ore me The forgoing instrument was acknowledged before me
this day of 1{� 20 y this day of !�20 ny
(Name of rson ckn edgi g) (Name of ack owl ing)
(Sig ture of Not ublic-State of Florida) (Signa re of Notary lic-State of Florida)
P sonally Known OR Produced Identification Pe onally Known 1„ i ication
ype of Identification Produced pe of Identifica tgced DESS
*: o� MY COMMISSION#FF 072984
Commission No. ti YPy- JESSICA,�07SON EXPIRES:Naverr 20
COMMISSIt Fk72984 Commission No. ••• b`�.) 17
*: 2017 Thru Notary Pu l c Underwrrlers
EXPIRES:November 25,
••• dThruNotaryPubliaUnderwrders
Revised 07/15/2014
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