HomeMy WebLinkAboutBuilding Permit Application Sep 21 2015 9:49AM HP Fax page 2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9.21.2015 Permit Number: 5 d 9 J 5 J
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RECUV D SEP 2]. 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: To Select from dropbox, click arrow at the end of line a L
Address: 265 NE Mainsail Street, Port St Lucie, FL 34983
Legal Description: RIVER PARK-UNIT 9-PART C BLK 79 LOT 14(MAP 34121 S)(or 2126-2710)
Property Tax ID#: 3419-570-0070-000-8 Lot No 14
Site Plan Name: Block No, 79
Project Name:
Setbacks Front Back: Right Side: Left Side:
P
Replace Like 3 ton Split System with 5KW heat for Like 3 Ton 14 seer Split System wit i 5KW heat.
4 lig
11tional work o e e Orme und er this permit—c ec a apply.
HVAC FIGas Tank E]Gas Piping _Shutters Q Windows/Doors
11Electric0 Plumbing ❑ EI Sprinklers Generator � Roof
Total Sq. Ft of Construction: 1166 S . Ft.of First Floor:
Cost of Construction:$ 2499.00 UtilitiesSewer Septic Building Heig t:
Name Daniel Siraco Name: Robert Hennis
Address:1957 SE Cheltenham Street Company: Air Control Air Conditioning and R frigeration,LLC
City: Port St Lucie State:FL Address: 5415 Silver Oak Drive
Zip Code: 34983 Fax: City: Fort Pierce State•FL
Phone No.772-359-2090 Zip Code: 34982Fax: 772-460-6613
E-Mail: Phone No. 772460-2665
Fill in fee simple Title Holder on next page t if different E-Mail: aircontrolac@yahoo.com
from the Owner listed above) State or County License: CACI 816015
1[.1E value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
Sep 21 2015 11:38AM HP Fax page 1 E d 1
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: —N t 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
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 you r Home Owners Association and review your deed for any restrictions which ma V 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-resid ntial use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your payin 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.
Int:L. s
_Signature 6f Owner/Lessee/Agent ggnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF saint Lucie COUNTY OF saintLuda
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged be ore me
this" 1%1 day of ernbA 20 IS by this 21" day of saptemner .20 16' y
1l[I�YYI
2iQ l VSO �� WilliamPalw1no
(Name of person acknowledging) (Name of person acknowledging)
L
(Signature of Notary Public-State of Florida j (Signature of Notary Public-State of Florida
Personally Known V/ OR Produced identification Personally Known x OR Produced Identi ication
Type of Identification Produced Type of Identification Produced
Commission No.f6 u s .fix Boa"ru (Seal) Commission No.Eezuasta r (Sea
4PIL11AMPAZLADW )
MYCOid111SSMIlEE1188516 �`►A=,•t;' , WOWISS
II EE 16
EXPIRES:June 1Z,201 EXPIRES:June 14,24 6
Revised 07115/2014 `'"W.m- Be,d r%UB4*MaW8+>�0� ° a Bandalthu8adpt1lahtt
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS