HomeMy WebLinkAboutBuilding Permit Application JUN/29/2015/MON 06:51 AM ARS Rescue Rooter FAX P. 001/005
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date., Permit Number: Lp
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
EIRREA
Address, vl� Y�fxcg_ 1�z I—
Legal Description, \AcLc\(_A0N Qiof S'
Property Tax ID -6 0 b bo�a_z_ 1 0 06 Lot No,_LA_k_
Site Plan Name: vk Block No.
. Ad_�, 4� \(a Y-\n
Project Name: �Aam5 i u)'IU1ch'm
Setbacks Front Back: Right Side: Left Side,
HIM me"wal
".1 1
161WIt,pm t
Replacing AIC, exact change out, no duct work with Cc'tC6-cr \m 'cr
EX.
;al •
AddltjonalworXtob_��Pertormed under this permit—check all t=app Y:
E]HVAC []Gas Tank DGas Piping L�Shutters F—]Windows/Doors
11 Electric F-1 Plumbing nSprinklers [ Generator 0 Roof
Total Sq.Ft of Construction; Sq.Ft.of First{
irst Floor,
Cost of Construction:$ 0qq q utilitie5:L]SewerF ]Septic Building Height,
'ion
WIN I'I I=0 91
Narrie Name: Zac5k,Dennis
Address:
Company: American Residential Services
—State: Address: 2800 US Hwy I
Zip Code:_13�q5j Fax: City. Vero Beaoh
State:FL
-9783
0 32960
Phone No Zip Code. Fax: 772 794
E-Mail: Phone No. 772 794-7221
Fill in fee simple Title Holder on next page(if different E-Mail. bdarbYO—
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/29/2015/MON 06:51 AM AAS.1?�cue Rooter FAX No, 772-7949783 P. 002/005
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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..
' s
gnature of Owner ee/Agent Slg ature of Contractq_rLLie6nse Halder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sf.Lu* COUNTY OF Stt_=aa
The forgoing instr ment was acknowledged before me The for Ding instr ment was acknowledged before me
this day of U 20 35-by this day of one 20 _Lri by
Dennfe Zecek Dennla Zscek
(N of person acknowledging) (Name of person acknowledging)
(Si ure of Notary Publlc-Sta of Florida) (Signature of Io ary Pub"11�',-REa5 of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced identification
Type of Identification Produced _ Type of Identification Produced
Commission No. FF220930 @0 rimission No, FF220930
^::•'' !`YN A DERBY BBYN A DERBY
MY ts
w EXPIRES April 15,2019 `
Revised 07/15/2014 EXPIRES"15,2019
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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