HomeMy WebLinkAboutBuilding Permit Application 07/02/2015 12:01 7724662417 SEACOAST SHEET METAL PAGE 03
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /✓ /-i 4 __. Permit Number: ;►�� / �
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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
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Address: 3125 GORDY RD
Legal Description:
Property Tax ID#: 2323-501-0074-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front„ Back: Right Side: Left Side:
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LIKE FOR LIKE 2.5 TON 16 SEER 5 KW A/C SYSTEM
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itlona wor to A e orme under tis permit-c et a appy:
0 HVAC n Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric Q Plumbing Sprinklers D Generator Roof
Total Sq. Ft of Construction: S •Ft, of First Floor:
Cost of Construction:$ 4671,00 Utilities:SewerSeptic Building Height:
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NamePHILLiP FORGET -_ Name: JOHN V LANGEL
Address:3125 GORDY RD _ - Company: SEACOASTAiC
City: FORT PIERCE State:FL Address: 2601 INDUSTRIAL AVE 3
Zip Code: 34945 Fax: City FORT PIERCE State:FL
Phone No.772-216-4239 Zip Code: 34946 Fax: 466-3053
E-Mail _ - Phone No_ 772-466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEACOASTAiR@AOL.COM
from the Owner listed above) State or County License: CA0016446
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
07/02/2015 12:01 7724662417 SEACOAST SHEET METAL PAGE 04
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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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in confilct with any applicable Home Owners AssQcfation 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 aur property.A Notice of Commencement must be recorded nd posted on the jobsite
before the first i pection. If u inte d to obtain financing,consult with lend r an attorney before
commencingor record' ur tice of Commencement. _
s
Signature f wner/LessecJA nt Signature of Contractor tcense Bolder
STATEORIDA STATE OF FLORI
COUN — LUCIE COUNTY OFsTL F
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of d` _, 20 by this day of IULv
JOHN V LANGEL-*t JOHN V tANG15pe
(Name of per n acknowledgin I {Name If erso nowledging
e
(Signature" azure o y ubli S ori a
TF y
Personally Kn n+ .` W86&R. _ Personaily 1
Type of tdentt ifs dicf� ,,_ Type of identificatl etlrVir
RO>y39Rot53 ftnr;gcNtit ry rvi .cam gip^ EXPIRES�gt 30-201a
Commission Commission No,
{d0?� TW FtoridsN8tary5Eroicu.C*M
Revised 0711512014
REVIEWS FRONT ZONiNG SUPERVISOR PLANS VEGETATION 5EATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS