HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO.MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/5/15 Permit Number: �1,.—00. 0 /0-'
�_. -- RECEIVED
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Building Permit Application JUN 5 1015
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: 8824 Champions Way
Legal Description: Lakes At PGA Village
Property Tax ID#: 3334-501-0077-000-3 Lot No.63
Site Plan Name: Block No. A
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF'WORK
A/C Condensor Change Out.
CONSTRUCTION INFORMATION:
Additional work to be nprformed under this permit—check all appy:
aHVAC Gas Tank ❑Gas PipingShutters Q Windows/Doors
Electric Plumbing OSprinklers E_Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3000.00 UtilitiesSewer USeptic Building Height:
OWNERAESSEE: _ :CONTRACTOR:
NameThomas G Spears Name: Marc Bergerman
Address:8824 Champions Way Company: All Tech Refrigeration, Inc.
City: Port St Lucie State:FL Address: 2377 SE Longhorn Ave
Zip Code: 34986 Fax: City: Port St Lucie State:FL
Phone No.772-215-5738 Zip Code: 34952 Fax:
E-Mail: Phone No. 772-398-4428
Fill in fee simple Title Holder on next page(if different E-Mail: mebergerman@comcast.net
from the Owner listed above) State or County License: CAC1813888
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL'CONSTRUCTION LIEN LAW INFORMATION
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 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
commencing work or recording our Notice of Commencement.
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Signature of Owner/LAeeLifimeonhV P i nature o ,Ro _rca icense Holder
STATE OF FLORIDA a•p _ STATE OF FLORIDA
COUNTY OF COUNTY OF ice_
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The forgoing instr nt was acknowledged bef s The forgoing instr ent was acknowledged before °°
this_ _day of 9. 20 � i �'�m this day of J A 20 J��y mO o
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(Name of person acknow dging) (Name of person acknoM ing) �T 9
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(Signature Notary Public-State of FI rida) / (Signature of NcMry Public-State of Flonda) U
Personally Known OR Pr uced Identification c/ Personally Known OR-Produced Iden ificatio
Type of Identification Produced Type of identification Produced
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Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS