HomeMy WebLinkAboutBuilding Permit Application 10/29/2015 11:35 561-4932701 ECM PAGE 02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICA71ON TO BE ACCEPTED
Date: �0' __(_5 Permit NurMer: o " C) -1 1
_ RECEIVED DCT 2 9-1015
Building Permit Application
Planning and Developmenr 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: Oklce ;P
Legal Description: � � V
Property Tax ID#: ;??3 Lot No. 13
Site Plan Name: _ Harp ___ Block No.
Project Namet `- � Kmao HAn
Setbacks Front, Back: Right Side: Left Side:
MEMENNEEMMEEMEM
LIKE FOR LIKE A/C CHANGE OUT W/ DL5 OW wea,--f- Djy,
5-�Q✓l 1+5S' ,'
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Additional work to be nertorMed unclerthis permit—c ec a appy:
HVAC LJ Gas Tank OGas Piping. _Shutters ❑Windows/Doors
L_I Electric ❑Plumbing ❑Sprinklers Generator El Roof
Total Sq.Ft of Construction: _ S . Ft.of First Floor:
Cost of Construction:$ u-3-11 -00 Utilities:'n Sewer❑Septic Building Height:
Name Name: JOSE RAMIREZ
Address: �.l G� comp,ny. EASTCJYASTMECHANICAL
City: r State:FL Address: 1500 N HIGH RIDGE RD
Zip Cade: �C"1�.P Fax: City: BOYNTON BEACH State:FL
33426 Fax: (561)493-2701
Phone No.�a-� �� lo�.S� ___ . Zip Code: ---
E-Mail:_ Phone No- (561)586-3739 EXT 2020
Fill In fee simple Title Holder on next page(if different E,Malh PERMITSORCMSERVICE.COM
from the Owner listed above) State or County License: CAC036812
If value of constructich is$2500 or more,a RECORDED Notice of Commencement is required.
10/29/2015 11:35 561-4932701 ECM PAGE 03
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERANGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:_
Address: Address:
City; - -- --._ -- State: City:
State:.*
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: ,Not Applicable BONDING COMPANY: Not Applicable
Name: _ Name:
Address: Address:
City:. - -- City:
Zip: Phone Zip: Phone:
1 certify that no work or Installation has commenced prior to the issuance of a permit:
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
In accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendment,'.
The following building permit applications are exempt from undergoing a full Concurrency review:'room'additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER-,'Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. if you intend to obtain financing, consult with lender or an attorney before
Commencing work or recording our Notice of Commencement.
Signature of Owner/Aqent' e$see Signature of Contra eta r/LicAns older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALMBeAmf COUNTY OF-Lm em" —
The forgoing instrument was acknowledged before me The forgoing 1nstrurr3Qot yeas acknowledged me
this day of C,� 20 15 by this.�day of ti�C•T ,Zo� by
JOSE RAM IREZ JO$C tiAMIRF7.
(Name of person acknowledging) (Name of person acknowledging)
(Signa ure of Notary Public.State of Florida) (Sign ure 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. GILLiAN C:HUr-K Commission No_ (Se,I�iLLJAN CHUCK
NOTARY PU13LIC
STATE OF fLORI A �, NOTARY Pwp
Comm#EE172182 cor QFLCR DA
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REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS