HomeMy WebLinkAboutBuilding Permit Application Jun 30 2015 7:19AM HP Fax Page 2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/3012015 Permit Number: 15'0(0° DE
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce ft 34982
Phone: (772)462-1553 Fax: (772)462-1579 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbax, click arrow at the end of line &`
T.
Address: 214 N Entrada Avenue,Port St Lucie, FL 34952
Legal Description: RIVER PARK-UNIT 1 i3LK 2 LOT 6(MAP34122N) (OR 2995-1037)
Property Tax ID#: 3419-501-0011-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
�1131 M' Mu'
Replace Like 2 ton split system with 5 kw heat for like 2 ton 14 seer split system with 5 kw heat
Additional warK to D e e mecal uncler t s errn t—c ec a appy:
ZHVAC Gas Tank ❑Gas Piping _Shutters ❑windows/Doors
Electric Plumbing Sprinklers Generator L1 Roof
Total Sq.ft of Construction:988 SQ.Ft.of first Floor;
Cost of Construction:$ 2499.00 Utilities:Sewer QSeptic Building Height:
Name Sergio Merino Name: Robert Hennis
Address:214 N Entrada Ave Company:Air Control Air Conditioning and Retrigeration,LLC
City: Port St Lucie State:FL Address: 5415 Silver Oak Drive
Zip Code: 34952 Fax: City: Fort Pierce State:FL
Phone N0.772-236-8525 Zip Code: 34982 Fax:772-460-6613
E-Mail: Phone No. 772-460-2665
Fill in fee simple Title Holder on next page{if different E-Mail: aircontrolac@yahoo.com
from the Owner listed above) State or County License: CAC1815015
If value of construction is$250D or more,a RECORDED Notice of Commencement Is required.
Jun 30 2015 7:19AM HP Fax page 3
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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
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINTLUCIE COUNTY OF SAINTLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this SOO,day of f/yi-e . 20 Lrby this;a 'day of _l C.Jf4.t 20 Lr by
W1111amPalladim 1 William Palladino
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida} (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No..M208515 7W Pit, (Seal) Commission No. EE20BS16 (Seal)
MYWV*M1EE2W8yYkt IAYCOIvW410M1EEmie
EXPIRES:June 14,2016 UNIES:June 11,2016
Revised 07/15/2014 ""14.%,WdA9elldidTlllllt?nd�otNiiry1pI1111I ' oFn dad 1b11BId�ltllofairlikrit�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS