HomeMy WebLinkAboutBuilding Permit Application 09/21/2015 08:56 7724662417 SEACOAST SHEET METAL PAGE 04
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -� al, L_l 5 Permit Number: ISG1_(% 4 a.
: '`,=' `°"' ' RECER"_70 SEP 2120i5
Building Permlit Application
Planning and Development Services
Buiiding and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL 3438.2
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
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PERMIT APPLICATION FOR: Mechanical
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Address: 2334 KEEN ROAD
Legal Description:
Property Tax ID#: 1431-322-01)01-010-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_.-._.. Back: Right Side: Left Side:
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LIKE FOR LIKE CHANGE OUT 5 TON 16 SEER 10 KW
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Mona wor to e e ormed un er is per ni --c ec a appy:
L�MVAC _Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing ❑Sprinklers ❑Generator Roof
Total Sq, Ft of Construction: S . of First Floor:
Cost of Construction:$ 6614.00 Utillties:n Sewer Septic Building Height:
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Name CLAYTON/JULIE HOLLEY Name: JOHN V LANGEL
Address:2334 KEEN ROAD Company: SEA COAST A/C
City: FT PiERCE State:_ Address: 2601 INDUSTRIAL AVE 3
Zip Code: 34946 Fax; City: FT PIERCE State:FL
Phone No.772-466-6915 Zip Code: 34946 Fax: 466-3063
E-Mail: Phone No. 466-2400
Fill in fee simple Title Holder ah next Page(if different E-Mail: TLSEACOASTAIFZ@,AOL-°COM
from the Owner listed above) State or County License: CAC016446
If value of construction is$2500 or more,n RECORDED Notice of Commencement Is required.
09/21/2015 08:56 7724662417 SEACOAST SHEET METAL PAGE 05
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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:
Add rens: 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 Coun 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
improvementsyour property. A Notice of Commencement must be recordgd and posted on the jobsite
before the firV' spection. If you intend to obtain financing, consult with len er or an attorney be re
commencin rk or recor ng ycAr Notice of Commencement.
,Zl/c A�v s
Sign a of Owner/Les a/Agent Signature of7Coctor/L—icenseH der
5T OF FLORIDA STATE OFDA
COUNTY OFSTLUCIE COUNTY OF STLUCIE
Th ing Inst acknowledge fore me The forgoing instrument was acknowle before me
th day o 20 y this " day of SEPT __ 2 by
Jo fL,- JOHN v LANGEL
(VA Pf person ac no ing) (Nameoffiqpn acknowledgl
Ignature tart' u lic-Sta of Florida) (Signat a of N ry Public-State o rI a .
Personal n x OR uced Identification Personally Kn wn OR Pro d Identification
Type of Identification Produced Type of Identification Produced
Commission No. •"*��', p�OY gt)LANGEL Commission No. (Seal)
.d. ..a
f•
MY QOMMISSION*FF148072
2e 18
Revised 07/1, R6j4e-a153 MY COMMISSION#FFIA8072
EXPIRES August 30,2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS