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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \d a0 15 Permit Number:
PECEIV_99-R!, r- OCT 20101
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
PROPOSED IMPROVEMENT LOCATION: .i
Address: 6809 THOREAU TERR
Legal Description. OLEANDER PINES BLK 1 LOT 21 (0.22 AC)(OR 1284-2398)
Property Tax ID#: 3415-705-0022-000-7 Lot No.
Site Plan Name: Frank G Takacs Jr Linda A Takacs Block No.
Project Name: Frank G Takacs Jr Linda A Takacs
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC CHANGE OUT 5TONS 19SEERS
[CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all that.appy:
❑✓—(HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers F�Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 9227.00 Utilities:In Sewer E]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name TAKACS,FRANK G JR. Name: RICHARD LEVINSON
Address:6809 THOREAU TER Company: SERVICE AMERICA
City: PORT SAINT LUCIE State:FL Address: 2755 NW 63RD COURT
Zip Code: 34952 Fax: City: FORT LAUDERDALE State:FL
Phone No.772-464-3568 Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100
Fill in fee simple Title Holder on next page(if different E-Mail: EPERMITSGROUP@SERVICEAMERICA.COM
from the Owner listed above) State or County License: CAC014619
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL• CONSTRUCTION LIEN LAW INFORMATION:
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:
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 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 undergo a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen ro and accessory uses to another non-residential use
R I G TO OWNER:Your failure to Record a Notice of ement may result in your paying twice for
mp o e ents to your property. A Notice of Commence en t be recorded and posted on the jobsite
fo t first inspection. If you intend to obtain financi g o s t with lender or an attorney before
c n 'n work or recordingour Notice of Commenc n .
s
_SIgn ure of Own Lessee/Agee Sign Co'r�trac -/License.Holder
- -
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE
The�orgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this `"'ll day of I (`) , 20 this 19 day of 10 ,20 J5:�'by
RICHARD LEVINSON RICHARD LEVINSON
(Name of person acknox&le g ng) (Name of perso ck owle Ing)
(Signa e o Pub c-St Florida) (Signa re ofYcation
ry Public-State of FloridaPer onally Kn ion° Per nally KnX OR Produced Identification
Ty I.e of Iden a IAC' oducedESSICADOTSON T e of Identi Produced
MY COMMISSION#FF 072984
;.°• :o EX PIRES:November,75,2Q17 Commission No. Seal)
,,• lh�eftVrtt
Co Ion i :. [oPotaryPublic ers
JESSICADOTSON
M�
OMMISSION#F 117 ORA
EXPIRES:November 25,2017
Revised 07/15/2014 Bonded Thru Notary Public Underwriters
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