HomeMy WebLinkAboutBuilding Permit Application 772-770-0064 ARS 08:04:01 09-01-2015 1/5
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
O
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
Address: Z ,-
Legal Description:
Property Tax ID#: Lot No. 9 -1
Site Plan Name: Block No._
Project Name:
Setbacks Front Back: Right Side: eft Side:
F t '• ,�..v. r .-z...-a - f�.».f"i'tf. r,,fY.. a£... :vv�..,�:�-.r.....s:...t. ;�.r ,...,, nom. "�_ .+ 6.IC- ...t .t.>J'4 _ r - _ ate,
Replacing A/C, exact change out, no duct work with ,r'r
COIVSTRULTIONitaI�C1RMAIiF}�V;T� nxE_ _
itiona wor to (e�e orme un er t is permit—c ec s appy:
HVAC LJ Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
LIElectric El Plumbing []Sprinklers []Generator Roof
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$_ ��� Utilities: Sewer Septic Building Height:
_
. . .... ..�
Name Name: Zacek,Dennis
Address: \ Company: American Residential Services
City: �� State:EL Address: 2800 US Hwy 1
DLQZip Code:� L 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 08:06:14 09-01-2015 2/5
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.
_Signature of Owner/Lessee/Agent Signature of Cont or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SLLude COUNTY OF Sl Lude
The forgoing instru ent w ackn wle ed before me The forgoing Inst ume t was a nowledgefd�before me
this�day of � G y this-_day of 20 J_...�by
Dennis Zacek Dennis Zacek
(Name of person ackno dging) (Name of person acknowledging)
{Signature of Notary Public-State of Flo da (Signature of Notary Public-State of florid
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Producedof Identification Produced
BETH A ;r� SETH A DERBY
Commission No. FF220930 rY'�• ;? ' bMMISSION FF22 mission No, FF220930 rp _RAMISSION M FF2209
EXP S 1 ,201 1 15.2019
.j, IRE April 5 EXPIRES APS
•. tri:..•' '•,!!„
1407f 3'J&0•SJ IA 1
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS