HomeMy WebLinkAboutBuilding Permit Application JUN/25/2015/THU 09: 17 AM AAS Rescue Rooter FAX No, 772-794-9783 P. 001
ALL APPLICABLE INFO MUST BC COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit RECEIVED
A'
Planning and Development5ervices JUN 2 5 .2015
Building and Code Regulation DIvislon
2300 Virginia Avenue,Fort Pierce Ft-84982 ti
hOAE:(77 62-1553 rave;(7 6�_�S�Q C'nmmprri �~/C��{P.SI�IP.L1flD
PERMIT-APPLICATION FOR: McChanlcal
Address: 150!5 1.4
Legal Description:&in\q�Dd C�ax2��S �x_(_ UK C— ` Lis 1 "J Less E
Property Tax ID#: 2-40(4 O U - 2- Lot No.
Site Plan Name: Block No. $ r'
Project Name: Ai)aci e f�_i'-l-h elhurp k)
Setbacks Front Back: Right Side: Left Side:
ampoyl _ M
Replacing A/C, exact change out, no duct work with --rot)
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b -11ditionalwork o e e Orme under t is permit—check a
1Iappy:
HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
Electric ❑Plumbing []SprinklersC Generator Roof
Total Sq.Ft of Construction: S Ft. L.
of First Floor:
do
Cost of Construction:$ Utilities: _Sewer JSeptic Building Height:
j EON:y � f N 1T-Ali" 59 •-
Name_A2W& Fa j',th Chore-h _ Name: Zacek,Dennis
Address: W!5 N1 '4-*d, 6t Company: American Residential Services
City: r f pi-erC-e State:FL Address: 2800 US Hwy 1
zip Code: Fax: Add City: Vero Beach State:FL
10
Phone No. '77_) y1oN ?j Zip Code: 02960 Fax; 772 794-9783
E-Mail: I�L i A Phone No. 772 794-7221
Fill in fee simple Title Holder on next page(if different E-Mail: bdsrby@ars,com
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/25/2015/THU 09:25 AM ARS Rescue Rooter FAX No, 772-794-9783 P. 002/005
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DESIGNER/ENGINEER: x Not App(icable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: state:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Nat 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,-W21J5,signs,screen rooms and accessory uses to another non-resIdentlal 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 job-site
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
—s
ignature of O /Lessee/Agent Siature of ContraaD411-1cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF-aLLUC18 COUNTY OF 511.00
The for&olng instrument was acknowledged before me The forgoing instrujent was acknowledged before me
this gL!�-day of I-ne- 20 L5—by this d25 day Of— . Cril-e __,20 J-�-by
Donnis Zarek
(Name of person acknowledging) (Name of person acknowledging)
c-State-of"a da
(Signature of Notary Public-Staik,6f Florida (Signature of� Notary 55b
Personally Known x OR Produced Identification Personally Known X OR Produced IdentIfIcation
Type of Identification Produced Type of identification Produced
Commission No 1`1`405130 C Mmissfon No. rF220930 DERBY
B A�My�
BETH A DERBY
my COMMI5S10
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EXPiRES POW
EXPIRES April 15,2018 114W
Revise16.2019
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07/15/2014 1 -.;.W 1"" 1-0,P
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS