HomeMy WebLinkAboutBuilding Permit Application JUN/05/2015/FRI 12:53 PM ARS Rescue Rooter FAX No, 772-794-9783 P, 001/005
ALL APPLICABL [NFO MPS TB COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � Permit Number JV W J I
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
230D Virginia Avenue,Fort Pierce F�34982
Phone:(772)462-1553 Fax,(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
Ogg lig 11
Address: oY r—,� Nj' �J
Legal Description:
Property Tax ID#. -llQ 6-2f-)-2—114-1 00 R Q)t-Q • t 1 QQ0I 0Q0' 0 Lot No.
Site Plan Name: aac-'Y-f-c" mayy, Block No.
Project Name: 't�C�('� Cy2yc) MaCK
Setbacks Front Back: Right Side: Left Side:
Replacing A/C, exact change out, no duct work with
itiona wor to ne orme un er t is permit—c ec a appy:
HVAC LJ Gas Tank []Gas PipingCGenerator
Shutters ❑Windows/Doors
11 Electric Q Plumbing ❑Sprinklers Roof
Total Sq.Ft of Construction: 5 Ft.of First Floor:
Cost of Construction:$ t-�1 �Q � Utilities:?Sewer O Septic Building Height:
Name Name: Zacek,Dennis
Address: 1 ,e ' Company: American Residential Services
City: lr— ?-ffc a State:V—L Address: 2800 US Hwy 1
Zip Code:'`..'-,'CA51 Fax: —I C6!> City: Vero Beach State:FL
Phone No. 1ltkLe �� - �J .� Zip Code. 32960 Fax: 772 794-9783
E-Mail: Py Phone No. 772794-7221
Fill In fee simple Title Holder on next page(if different E-Mail: bderby@ars.corn
from the Owner listed above) State or County License: CMC1249753
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
JUN/05/2015/FRI 12:53 PM ARS Rescue Rooter FAX No, 772-794-9783 P, 002/005
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address; Address:
City: State: City:— State:
Zip: Phone: Zip: Phone: _
FEE SIMPLE;TiTLE HOLDER: x Not Applicable BONDING COMPANY: x 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.
I �l 2t S
_Signature of Owner ee/Agent Si tune of Contractor Licen a FWIder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SLLmtc COUNTY OF SSLUdc
The forgoing instru ent was acknowledged before me The forgoing instr ment was acknowledged before me
this,1�„day of 20 1- this; day of. 20 by
Dennla Zaceic Qennis Zacek
1>Ia a off personknowledgin8) ( e of peedgfng}
�ftiKture of y Public-St a of Florida) ( ure of Notary ubllc-State of F rida}
Personally Known x OR Produced identification Personally Known x OR Produce identification
Type of Identification Produced Type of identification Produced
Commission No. FF220930 "' :(seal)EETN A DERE Com ission No. FF220930 :�' 1.
_ (S@STN A DERBY
MY COMMISSION#FF 0930 ••; MY CommissioN a FF2Zo93
EXPIRES 15,2019
Revised 07/I5/2014 IAe''''ie'u si Pialaaa«a ervlee.car 4C7Ia`�U'S3 Fwraaanos� Se �cs.cwr
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS