HomeMy WebLinkAboutBuilding Permit Application Jul 01 1509:03a Dodd EnterprisesInn. 772-335-3310 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0613012015 Permit Number: 115;0ZP• IC)SS�
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginio Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercia I Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Add ress: 811 Nettles Blvd
Legal Description:
Parcel ID#4502-501-0997-000-6
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out 3 ton 13 seer Carrier Bryant st cool pkg unit 8 kw heater like for like
CONSTRUCTION INFORMATION:
((""Additionalwor to e e orme under this permit—check a appy:
(HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof
Total Sq, Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 3500.00 UtilitiesSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Teddy&Tammy Osborne Na me: Vance R Corbin
Address:811 Nettles Blvd Company: Dodd Enterprises Inc
City Jensen Beach State:Fl Address: 1296 SE Industrial Blvd
Zip Code. 34957Fax: City: Port St Lucie State:FI
Phone No.(304)880-6282 Zip Code: 34952 Fax: 3353310
E-Mail: Phone No. 398-2344
Fill in fee simple Title Holder on next page(if different E-Mail: doddenterpdses@dodd.com
from the Owner listed above) State or County License: CMC1249958
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Jul 01 1609:03a Dodd Enterpris77?X3;5-3310 p.3
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 priarto the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize thepermit 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.
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_Signature of Owner/ ssee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -3k (Uc t' COUNTY OF
The forgoing instrumf nt was acknowledged b fore me The forgoing instrumept was acknowledged before me
this lx>day of 20 1 y this-�5D day of 20 1�-by
_(Name of person acknowledging) (Name of person acknowledging)
(Signature of ITotary Pub ic-State of Florida) (Signature of�if tart'Public State of Florida)
Personally.Known OR Produced Identification Personally Known ✓ OR Produced Identification
fy ,e�aE fde�tti6eation.Produced Type of Identification Produced-
-C,rsmrssibh. -�('E&STIPHIE Commission No. Q
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