HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ta• S Permit Number: 0 ' D9-7
RECEIVED
Building Permit Application
Planning and Development Services JUN 3 0 2015
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:.(772)4.62-1553 Fax:(772)462-1578 Commercial 04s _ J
PERMIT APPLICATION FOR.: Mechanical
PROPOSED IN.PROVEMENT LOCATION
Address: Y "OCL
Legal Description:_y1��iUC1 �Q� 'J d ICS��_ \ V 2..
Property Tax ID#: 131 -'nC7)1 - (f 1C of%-CQC 2 - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Site:
DETAILED DESCRIPTION OF WORK
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CONSTRUCTION INFORMATION:
Additional wor oe e orme under this permit-check a a,appy:
HVAC FI Gas Tank _ ❑Gas Piping Shutters ❑Windows/Doors
11 Electric 0 Plumbing ❑ _Sprinklers Generator Roof
Total Sq. Ft of Construction: 2EL3 Sq. Ft.of First Floor:
Cost of Construction:$ L�L+2-C) Utilities: Sewer OSeptic Building Height:
OWNER/LESSEE CONTRACT
Name -Name. RALPH WARREN
Address. n t (ZJ Company: AIRFLOW A/C AND.HEATING
City: State: Address: 50 NE DIXIE HWY SUITE D-1
Zip Code:. --3 to _ Fax: City: STUART State:FL
Phone No.: "Tall Zip Code: 34994 Fax: �^
E-Mail: Phone No. 772-781-2665
Fill In fee simple Title Holder on next page(if different E-Mail: airflowacfl@gmail.com
from the Owner listed above) State or County License: CAC1817930
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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UPP!EMENTAE CONST i'3CTI{)N LIEMR
N LAW:IN OF TICI
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: _ Name:
Address'
Address:
City: State: City: State:
i
Zip: Phone; Zip: Phone:
-
Y.
FEF SIMPLE TITLE HOLDER: _ Not Applicable � BONDING COMPANY: :Not Applicable t.
Name: Name:
Address: I Address:
City.- City:
�Zip: � Phone: Zip: Phone��. r.
OWNER/CONTRACTOR AFFIDVIT:.Application is hereby made to obtain a permit to do the work and installation as indicated.
i ierzifr that no work or installation has commenced prior to the issuance of a permit.
st Lucie Crsant}y makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
rrh+cn.is in conflict with any applicable Home Owners Association rules,bylaws or and coveriants 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 thatl will.in all respects,perforin the work
in accm;iai,ee with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The:fallowing building-permit applications are exempt from s,ndergoing a full concurrency review:room additions,
aC+:essonstructutes,swimming pools,fences,walls,sign;,scmen rooms and accessoiy uses to another nota-residential utte
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 art attorney before �
commencing work or rerordingyour,Notice of Commencement.
r (g attire of 0 n,r/Agent/Lessee i $ignahlreompritractor License f folder
STATE OF FL RIDA_✓ STATE OF FLORIDA
' I COUNTY OF t
COUNTY CIF ~
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Pine for���n instrument was acknowledged before me The forgoing instrument was acknowledged before me
;tis `_'t av of 1�S'� 20-M-by this ddy
f (Name of person acknowledging) (Name of persons acknnwiedjing}
j tyignature of Notary Public-State of Florida I {Signawre of Notary Pul>fir State of Florida)
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IParsonally Known � OR Produced Identification_— � l7i rsonasly Known Produced Identification—____- �
Type of Identification Produced— type of Identification Produced i
o6intnissiun No. tN=$IWAH RUSSELL Commission tic.._ 5,a`N;�A('�, 1�804AH RUSSELL
wuuc,,_
tyr'ay1. .'ens , Notary Public State of Florid:
Notary Public-State of Flo2i0d'$ c' om Lies Nov 30.2r'
M,=-My-Eom�kE� ---. --_ `- + MyC�ta ExIL
•Q? Commission#FF 179630 s'"r o4.`" Commission#FF 17963
y r Oma~ Comms �I OFf bg
evised 071`15i` }f;ye of fro?: Bonded through National Notary Assn. '�a,„cs�` Bonded through National Notary
REVIEWS FRONT ° ZONING SUPERVISOR PLANS VEGETATION SEA-PJRTL€ MANGROVE � t
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