HomeMy WebLinkAboutBuilding Permit Application JUL/27/2015/MON 08:31 AM AAS Rescue Rooter FAX No, 772-794-9783 P. 001
ALL APPLICABLE II�FO M�Sff�f B�MPLETEb FOR APPLICATION TO BE ACCEPTED
nc Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
.2300 Virginld 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: 4J�bA k0cdeA_-,cQd hr `_�� Pierce FL-_
Legal Description:. 14of idau PineS SI J Ph^aSC_XE Lo t 4439
Property Tax ID#: 131-3• T,0a • 00 f;�- 00 0 Lot No._*�
Site Plan Name: Wang , ko& Block No.
Project Name: w&iasg
Setbacks Front Back: Right Side: Left Side:
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Replacing A/C, exact change out, no duct work with 7�vn I ��rv`�Er, f 7 SVC r
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AclilitionalworKtoj)p- -nerrormeaun ert ispermn—check all appy:
OHVAC Gas Tank []Gas Piping _Shutters L__..I Windows/Doors
11Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. 5t of Construction: S Pt.of First Floor:
Cost of Construction:$ ��`L� 00 Utilities:ESewer DSeptic Building Height:
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Name akinS, Name: Zacek,)Dennis _
Address: �q2co- &dWt][ 1 by- Company.-American Residential Services
city: r+ Pl ercf_ FL -state:_ Address: 2800 US Hwy 4
Zip Code: 6EI51• Fax:_ N JA City: Vero Beach State:FL
Phone No. _- Zip Code: 32980 Fax: 772 794-9783
E-Mail: 1 A Phone No. 772 794-7224
Fill in fee simple Title Holder on next page(If different E-Mail: bderby@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. i
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JUL/27/2015/MON 08:32 AM AAS Rescue Rooter FAX No, 772-794-9783 P, 002
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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:
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
commencin work-or recording our Notice of Commencement.
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Signature of Ow r/Lessee/Agent Signature of Contr§efor/Llcense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF at-Lucie COUNTY OF stu,.i.
The forgoing instru nt was acknowledged before me The forgoing instru en was acknowledged before me
this 4a day of 20 51.y this�_T day of 20 by
Dents Zaoek Dennis Zscak
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State lorida) (Signature of Notary Public-State Morida)
Personally Known x OR Produced Identification Personally Known x OR Produced identification
Type of Identification Produced Type of Identification Produced
mmission No. FF220930
Commission No. FF720930 TH A DERBY k: ea 69TH A DIS
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RIM
.4 ISSION tM FF220 30
EXPIRES April 15.2099XPIRES April 15.20,
Revised 07/15/2014 `�'"�eo-ors�
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLEi'E
INITIALS