HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 _
Date: Permit Number: I " Ono
WNW -.
RECEIVED
Building Permit Application
Planning and Development Services JUL tl q
3, 2015
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue,Fort Pierce FL 34982 StLucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Plumbing
PROPOSED IMPROVEMENT LOCATION:'
Address: 5301 DEER RUN DR
Legal Description: HOLIDAY PINES
Property Tax ID#: 1313-502-0030-000-4 Lot No.
Site Plan Name: Zhenli L He Xiaoe Yang Block No.
Project Name: Zhenli L He Xiaoe Yang
Setbacks Front Back: Right Side: Left Side:
-DETAILED;DESCRIPTIONfOF WORK:
AC CHANGE OUT 5TONS 15SEERS 10KW
tONSTRU.CTIO,,N INFORIVI"ATION
Additional work to be nertormed under tispermit—check all that appy:
HVAC Gas Tank F]Gas Piping _Shutters Q Windows/Doors
1-1 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 4500.00 Utilities:CnSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Zhenli L He Xiaoe Yang Name:
Address:5301 DEER RUN DR Company:
City: Fort Pierce State:FL Address: 2755 NW 63RD COURT
Zip Code: 33309 Fax: City: FORT LAUDERDALE State:FL
Phone No.772-971-5854 Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100 EXT 5673
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.
SUPPLEMENTAL CQNSTRUCTION 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 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 nd accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Noti of Com encement may result in your paying twice for
i ovements to your property. A Notice of Comm n eme must be recorded and posted on the jobsite
b o e first inspection. If you intend to obtain fi ani onsult with lender or an attorney before
co q1 g work or recording our Notice of Com n e t.
s
_Signature of Owner/Lessee/Agent S na-__ e o�f�Contracto_r/Llceiise Holder T—
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF saint lucie COUNTY OF saintlucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 _by this 7 day of 7 20 by
RICHARD LEVINSON RICHARD LEVINSON
(Name of person ac i dgin ) (Name of person acknov� gi g)
(Signatu lc-State of Florida) (Sj atur of No /rub -State of FloridaPersonally Kn wn XOR Produced Identification Perso ally KnownOR Produced Identification
Type 4f Iden Ificatio rq uced TY p of Identification Produced
Co missi n No. I (Seal) Com -Seal)
""W PW" JESSICA DOTSON
JESSICA DOTSON �� °
My COMMISSION#FF 0'12984
My GQMMIbtjIUN*1'r ;s• S:November 25,2017 r
�+ EXPIRES:November 25,2017 "?;qf �Q` Bonded Thru Notary Public Unde.,M.s
Revised 07 Bonded ThruNotary Publ'teUnda-rilers
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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