HomeMy WebLinkAboutBuilding Permit Application 772-770-0064 ARS 10:29:53 08-27-2015 1/5
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -;L1 Permit Number:
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RECEIVED AUG 2 7 2015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
� POSIUYIIVIPR01/ X1/1ENT'L`OCAT!„ �
Address: 5 q_ q
Legal Description: Pf1�( �-i nD �'V,nreS 0\0CIS2 2r a'3'
Property Tax ID#: \312 G • O V - 000 ' Lot No.
Site Plan Name: lk k_11 e±:i:: , ar0)i U n Block No.
Project Name: 1, � 14 ”
4 , �(� _(�
Setbacks Front Back: Right Side: Left Side:
�QTA(l;£RDEC131PTION 0 WORD s f� W
1'50r
Replacing A/C, exact change out, no duct work with on
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Additional work toe Dertormea under this permit-check all tM apply:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
L- Electric El Plumbing F]Sprinklers a Generator Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ Utilities Sewer OSeptic Building Height:
OWNER/J.ESSEx M 3 .ax ri ,A k �r 4CONTRACTOR
Name 1 y-D k 0 Name: Zacek,Dennis
Address: ZG t `�i-0-y- Company: American Residential Services
City:_�A: i 2lrG State: e L Address: 2800 US Hwy 1
Zip Code: C Fax: City: Vero Beach State:FL
Phone No. Zip Code: 32960 Fax: 772 794-9783
E-Mail: Phone No. 772 794-7221
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.
772-770-0064 ARS 10:32:08 08-27-2015 2/5
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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.
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_Signature of Owner/Lessee/Agent Signature of Contrbetor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF s:.lude COUNTY OF SR.d.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ,day of 20 �by this day of ) 20 by
Dennis Zacek Dennis Zacek
(Na erson acknowledging) (Na a of person acknowledging)
(Signature of Notary Public-State of F da) (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. :ia' ' :(Seal BETH A DERB FF220930 ;'N"' ( WH A DERBY
FF22DS30 ) Com ISSIOn No. $
COMMISSION#FF2 0030 MY COMMISSION 0 FF220931 EXPIRES April 15,20 9RES Apd 15-2Q1
140713980'53 F1oPdaNM* r.e'WA-=
14071398-0'53 FbidsNaa tvc�.00n'
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS