HomeMy WebLinkAboutBuilding Permit Application � 1 � 2- 7
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: o 5 Permit Number: 1 5�l as 11
F
RECEIVE JUL O 12015
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: 413 EUROPEAN LN
Legal Description. PALM GROVE S/D BLK H LOT 6
Property Tax ID#.. 3410-503-0216-000-9 Lot No.
Site Plan Name: Jacqueline Allard Block No.
Project Name: Jacqueline Allard
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION SOF WORK: '
AC CHANGE OUT 2.5TONS 15.5SEERS
KW
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check a appy:
❑✓ HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 3600.00 Utilities:cn Sewer 0 Septic Building Height:
OWNER/L(SSEE: CONTRACTOR:
Name Jacqueline Allard Name: RICHARD LEVINSON
Address:413 EUROPEAN LN Company: SERVICE AMREICA
City: Fort Pierce State:FL Address: 2755 NW 63RD COURT
Zip Code: 34982 Fax: City: FORT LAUDERDALE State:FL
Phone No.772-240-1982 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@SERVICEAMERICA.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.
Sl1PPLEMEN.TALCONSTRUCTION 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 Coun y Amendments.
The following building permit applications are exempt from undergoing a full concurr ncy review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accesso y uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notic o ommencemen may result in your paying twice for
i p ov ents to your property. A Notice of Comme ce eRen
ust be recorded and posted on the jobsite
b fo h first inspection. If you intend to obtain fin ci gsult ith lender or an attorney before
co m ci work or recordingour Notice of Comm ce .
s
_Signat o Owner/tes`se'e/Agent -_:i SW a ure of Conteactor/Llce se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SA1NTLUCIE
ThefaV
ping instrument was acknowledged, re me The forgoing instrument was acknowledged before me
this day of 20J0 by this 29 day of 6 20
RICHARD LEVINSON RICHARD LEVINSON
(Name of person ackno a ging) (Name of M
rally
f ry Public- Florida) ignatu
Florida )
n 0 roduced Identification Perso Ily KnownOR Produced Identification
ation Produce• -ter Type f Iden if ced
JESSICA DOTSUN
MY r;.
mmission JESSICADOTSON (Seal)
Commission No. '_� EXPIR ember 25,2017 4;.; Pr';�;
'+ o° Bonded ThN Notary Public Under++iters ?*: a; MY COMMISSION#FF 0729&t
of, _ .tea• EXPIRES:November 25,?.017
u.eotjonued I n �Ia
Revised 07/15/2014
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