HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: August',2015• Permit Number:
RELE11.7-D AIJG 0 ( 2015
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Building Permit Application
Planning and De�velopmeAt Services
Building and Code Regulation D/vlslon
2300 Virginia A enue,Forl'Plerce FL 34982
Phone:(772)4 2-1553 Fax:(772)462-1578 Commercial Residential XXX
ERMIT APPLICATION FOR: Mechanical
_ `[: ,PROVEMf:N7�;0:Ci4Tl17N:• :l,`,'!•;.::,.• ;:;y.••. •� •.::•:•
ddress: 3351 T} in Lakes Terrace #105
egal Descriptio : Lakeshore Village of Meadowood-Phase I BLDG 3008 Unit 105(OR 3749-731)
roperty Tax ID 4. 1327-704-0089-000�S Lot No.
Site Plan Name: Block No.
roject Name: F eman
etbacks Fron Back, Right Side: Left'Side:
77
hange out existing A/C unit: Rheem 3 ton 15 seer, HP, $plit System w/ D kw Heat
Condenser: hl#15PJL3601 $#W361426401
Jr Handler: #RHLL-HM3617JA136 S#W011403347
4",clat-t-10-nalworico Orme under this permit.--c ec a appy:
Z✓HVAC 0 Gas Tank ❑Cas Piping _shutters o windows/Doors Ll
Electric 0 Plumbing ❑Sprinklers a Generator 11 Roof
T II tal Sq.Ft of Co I struction: Sq.Ft.of First Floor:
Cbst of Construct on:$ 5,000.00 Utilities: Sewer Septic Building Height:
:.:
:.•A. Ic.
Nime Jerry Freeman ""'• .'r.;;,;:
Name: Sherrled O Watson
A dress:3351 7w n Lakes Terrace#105 Company: ProMag Energy Group
CI V: Ft.Pierce _ _ State:FL 49Address•• 4205!11'2 Metzger Road
Z p Code: 351 _ Fax:_ _ City. Ft.Pierce _State:FL
P one No,561-77 -0999 Zip Code: 34947 -Fax: 772-2524831
E Mail• Phone No. 772-467-3227
R I in fee simple title Holder on next page{if different E-Mail: lisai@promagenergygroup.com
fr,I m the Owner listed above) State or County License: LMCA 48033
If value of constru Ion is$2500 or more,a RECORDED Notice of Commencement is required.
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bEsIGNERZ EN (NEER: xxx_Not Applicable MORTGAGE COMPANY: Not Applicablie
Name: __. Name*
ddress: Address:
ity: I state: City: state,
Name:
I _ Phone: Zip: Phone:
PEE SIMPLE TILE HOLDER: x�« Not Applicable BONDING COMPANY: Not Applicable
ame: Name:
ddress: I Address:
pity i City:
Zip: I Rhone: Zip: Phone:
I
I certify that no ork or Installation has commenced prior to the issuance of a permit.
St.Lucie County akes no representation that is granting a permit will authorize the permit holder to build the subject structure
1*hlch is In con I with an applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
tructure.Please onsult w h your Home owners Association and review your deed for any restrictions which may apply.
In consideration o the granting of this requested permit,t do hereby agree that I will,in all respects,perform the work
7,he
accordance wid the approved plans,the Florida Building Codes and St.Lucie Co6nty Amendments.
following buildingI permit applications are exempt from undergoing a full concurrency review:room additions,
a cessory structures,swimming pools,fences,walls,signs,screen rooms and accessary uses to another non-residential use
ARNING TO OWNER:Your failure to Record a Notice of Commencement may result In your paying twice for
pprovementso your property,A Notice of Commencement must be recorded and posted on the jobsite
efore the first Inspection. If you intend to obtain financing,consult with lender or an attorney before
c mmencin w rk or recordin our Notice of Commencement.
I a L&I 04 .
Signature of Owner/Lessee/Agent Signature of Contractor License Holder
S ATE
OF FLOR LSA STATE OF Elt7�tIDA
OI,INTY OF ss w __ COUNTY�l"sLiLaaEe
he forgoing instLmen!was acknowledged before me The forgoing instrument was acknowledged before me
t is_„_,day of 20 uby this day of A t�G . �,20 jIr-, by
Lisa Mane La" sww Llaa McAC LuwmcO
(Name of person acknowledging) (Name of person'acknowledging)
LOW{ ignature of Notafly PublIct State of Florida) (SE Lure of Notary Publi
,....,,,
LISA MARIE LAWRENCE
P rsonalty Known 0 Prp� )dentaf�Sii'lAARiE LAWRE Pers ally Known,� g � � _tdbE�ifila0itort Ssite at,
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••��� o tied Through National Nola yAssn.
evised 07/15/�014
R IEWS C RONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
LINTER REVIEW REVIEW REVIEW REVIEW REViE~W REVIEW
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INI�IALS
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