HomeMy WebLinkAboutBuilding Permit Application 10/12/2015 10:36 5615863739 ECM PAGE 02
ALL APPLICABLE IN1lFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i0-Q- 1 5 Permit Number:
RECEIVED OCT.12 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: Mechanical
Address: 11
Legal Description: a3 v1, a
Property Tax ID#; 164. 'z5' + ' 1 Lot No.
Site Plan Name:_�.AA � r� W _.v.__ Block No.
Project Name: hAl2LAW5
Setbacks Front Back: Right Side: Left Side:
LIKE FOR LIKE A/C CHANGE OUT ,... F 1CI,W 726 •—5i011 1+91a-e�r 10"
MOO+-( V-SP M A O+.qJ K
AOclitional wor to e ertormed unclertnis permit—ClIeCk all appy:
HVAC Gas Tank ❑Gas piping Shutters Windows/Doors
0 Electric 0 _Plumbing Sprinklers �Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ W_.It01-0-0 utilities: Sewer Septic Building Height:
} a, �
Name Name= JOSE RAMIREZ
Address: ft Company: EAST COAST MECHANICAL
City: , —State:F'If_ Address: 1500 N HIGH RIDGE.RD
Zip Code: �n Fax: ��,k� City: BOYNTON BEACH State:FL
U11Y
Phone No. 1 D 1u�✓ !"' � Zlp Code: 33426 Fax. (561)493.2701
E-Mail: Phone No. (561)586=3739 EXT 2020
Fill in fee simple Title Holder on next page(if different E-Mail: PERMITS@ECMSERVICE.COMfrom the Owner listed above) State or County License:. CAC036812
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
10/12/2015 10:36 5615863739 ECM PAGE 03
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DE ENGINEER: r Not Applicable MORTGAGE COMPANY: Not Applicable '
Name: - Name: -----
- _-_ - Address:
Address: — —
City: - --- State: City: _ State: ... --
Zip: Phone: _ Zip: _.._. Phone: --TFEE SIMPLE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _-,_,Not Applicable
Name: Name:
Address: i 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,;hat is ranting a ermit will Authorize the permit holder to build the subject structure
Which is in conflict with any applicable Home Owners ASSoGatlon rules,bylaws qr ang ov�enants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your peed 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 roams and accessory uses to another non-resldential 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 recordin our Notice of Commencement.
Signature of owner/ nf'j essee Signature of Contractor/Li ns older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALmw-AcH COUNTY OF P+XMACH
The forgoing instrument was acknowledged before me The forgoing Instrument was acknowledged before me
I
this j day of oar_ ____—_ 20�by this 12day of 61-,1- zojffby
JOSE P MIRE2joefi RWIREZ Q#AJM CKXK
(Name of person acknowMEMIMIA'L=38
NOTARY PUBIX (Name of person acknowledgin STATP-Y
STA'M OF F60M1l:r► owa s FM1112 I
(a0urimM�61Y2'lgit OonKrdl�E1TZ14+t ;
�l AWA Il
(Sigribture of Notary Public-State of Florida) (Si tore of Notary Public-State of Florida)
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Personally Known x OR Produced Identification , Personally Known _x. OR Procured identification
Type of Identification Produced _ Type of Identification Produced._^ ;
Commission No. Commission No. (Seal) I
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Rcvised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
GATE ^T
COMPLETE
INITIALS ��