HomeMy WebLinkAboutBuilding Permit Application 09/28/2015 07:59 7724662417 SEACOAST SHEET METAL PAGE 02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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
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Address: 13513 S INDIAN (RIVER DR
Legal Description:
Property Tax ID#: 4509-804-0037-000-0 Lot No._
SitePlan Name: Block No-
Project Name.
Setbacks Front Back: Right Side: Left Side:
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LIKE FOR LIKE 16 SEER 2 TON 8KW A/C CHANGEOUT
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ZHVAC Gas Tank ❑Cas Piping _Shutters ❑Windows/Doors
❑Electric ❑Plumbing []Sprinklers Generator Roof
Total Sq.Ft of Construction: e S Ft.of First Floor:
Cost of Construction:$ 5500.00 Utilities:11SewerSeptic Building Height:
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Name STEVEN SKOBLICKI Name: JOHN V LANGEL
Address.,13513 51NDIAN RIVER DR APT 604 Company_ SEACOAST AIG
City: JENSEN BEACH State:FL Address: 2601 INDUSTRIAL AVE 3
Zip Code: 34957 Fax: _ City: FORT PIERCE State:FL
Phone No.772-341-8895 Zip Code: 34946 Fax: 7724663053
E-Mail: Phone No. 7724552400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEACOASTAIR@AOL.COM
from the Owner listed above) State or County License: CAC016446
If value of construction is$2500 or more,a RECORDED Notice of Commencement fs required.
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09/28/2015 07:59 7724662417 SEACOAST SHEET METAL PAGE 03
DESIGNER/ENGI NEER: 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:
Ad d ress: Address:
City: City:
Zip: 'Phone-, Zip: Phone,
1 certify that no work or installation Ilas commenced prior to the issuance of a permit.
St,Lucie'0 un,4 makes no representation thatis granting a permit will authorize the P errnit holder to build the subject structure
which is in con Ict with any applicable Home Owners Association rules, bylaws of and covenants that may restrict or prohibit such
structure.P,Iease consult with your Home Owners Association 2nd 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 recorcjed and posted on the jobsite
before the firstjospection. If you intend to obtain financing,consult with 1,eyI'der or an attorney before
commencinx wfivk or reciatAngvour Notice of Commencement.
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STAT FLORIDA STA E ��'c�A
COUW0 ST LUCIE COU C7F
OF NT
The�%ng instrument was acknowledged before me The forgoIng instrument was acknowledged before me
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gnat f tate (Signature of ic- tat of FI6fduY—
EXPIRES A 2018 *
Commission No, Commission No'.
10-corn otarySery1ce.c9m
Revised 07/1$/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANQROVE-:
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLFTE
INITIALS
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