HomeMy WebLinkAboutBuilding Permit Application Oct 07 2015 11:39AM HP Fax page 2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date! � 1d\ 1`3 Permit Number: IIS 4 -O )
RECEIVED OCT 0 7 2015
I Permit A i ati
Building pp! n c o
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 X Residential
PERMIT APPLICATION FOR: To Select from dropboll click arrow at the end of line �C
Address: 290 SW Prima Vista Blvd;Port St Lucie, FL 34983
Legal Description: 293840 FROM NECOR OF SEC RUNS 89 Ill MIN V SEC W14CSFTALG N SEC Ill SOO DEG 18 MIN 30 SEC E20211 9 FT TOPO S,THCONTS00
We 10 MW008WEM Fr.VH MADDOG41 MN TDSECS71IEfT,TH N WMG 19 MN20 EEC W425FTTO PC OF CRCtiWE TO IFFT,R0F2E FT,THHWLYALOAROOF CURVE MITI FT TO P OF TANG OF Ol THSMIDE041 EECW YMFTTO FOG(CDSAq
Property Tax ID#: 3429-134-0001-000-5 L t No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Replace 7.5 Trane ton split system with 7.5kw heat in church for Like Trane 7:5 ton 11 seer split
system with 7.5kw heat
Additional work o be e orme uncler this perms —ChecK all tUtc1pply:
HVAC Gas Tank- ❑Gas Piping Shutters Q Windows/Doors
Electric Plumbing OSprinklers O Generator O Roof
Total Sq.Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ Z yRa- 0"> Litilities:ll Sewer O Septic Building Height:
E
Name Bishop Of Diocese Palm Beach Name: Robert Hennis
Address.PO Box 109650 Company:Air COntrol Air Conditloning&Rol dgeration, LLC
City: Palm Beach Gardens State:FL Address: 5415 Silver oak Drive
Zip Code: 33410 Fax: City: Fort Pierce State:FL
Phone No.772-878-1215 Zip Code: 34982Fax:772-460-6613
E-Mail:NiA Phone No, 772.460-2665
Fill in fee simple Title Holder on next page(if different E-Mail: aircontrolac@yahoo.com
from the Owner listed above) State or County License: CAC1815015
If value of construction is$2500 or more,2 RECORDED Notice of Commencement is required.
Oct 07 2015 11:39AM HP Fax page 3
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _No Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone- Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Nat Applicable BONDING COMPANY: .Not Applicable
Name: Name: '—
Address: Address
City: City:
Zip: Phone: Zip: Phone:
I certifythat 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 restrlctionsvwhich 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 payingtwice 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 Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFsalntl.-C-la COUNTY OFsalntt„aa
The foroing instrument was acknowledged before me The forgoing instrument was acknowledged be are me
this 734'-dayof"54p4e 6w . 20 Aeby this aim day of S"'embef 20 9� y
Wlplam Paramno l Mom Palladino
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (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.EE208518 ��RVPO ,,,;,.PAUJIDINO Commission No. EE20851e (Sea )
*AVA* MYCOIf1NIESgNt.EE20651fi `;."••. wwa
'+�.�eaa`0� Soneea7lruelr�petNofarys«tlree � EXPfAEii:J rtl#
Revised 07/15/2014 +4 EXPIRE
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLEMANGROVE
DATE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
COMPLETE
INITIALS