HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7728710863 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
4 RECEIVED OCT 23 -2015
M
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 xxxx
PERMIT APPLICATION FOR: Mechanical— �j y��
S�C7,! -
M M _L - - -
Address:
echanicai—
Address: 9440 Meadowood Drive#204
Legal Description: Quail Run Village Bldg 2 Unit 204 (or 1775-1592)
Property Tax ID#: 1327-703-0022-000-5 Lot No.
Site Plan Name: 9440 Meadowood Drive#204 Block No.
Project Name: Elkin
Setbacks Front Back: Right Side: Left Side:
Like for Like A/C system replacement
ROOF
5 TON
10KW
"M
Additional war to be Per ormed unclertnt cz permit—cheCK all Mat apply:
F6/IHVAC Gas Tank Das Piping Shutters []Windows/Doors
Electric I Plumbing
Sprinklers Generator 0 Roof
F I
Total Sq. Ft of Construction: Sq.Ft. of First Floor:
Cost of Construction: $ 6332.00 Utilities: 115ewerFseptic Building Height:
Name Dennis Elkin Name: Don J Miranda
Address:2228 Van Rensaelaer Drive Company, Miranda Plumbing&Air Conditioning
City: Niskayuna 5tate:NY Address: 750 NW Enterprise Drive
Zip Code: 12309 Fax: City: Port St Lucie State:FL
Phone No.518-527-0925 Zip Code: 34986 Fax: 772-871-0863
E-Mail;elkin2228@hotmail.com Phone No. 772-878-5123
Fill in fee simple Title Holder on next page(if different E-Mail: LDIODATD@MIRANDACOMPANIES.COM
from the Owner listed above) State or County License: CACI 815486
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Miranda Plumbing&AC 7728710863 p•3
r:•fN.:'_"..3.".'i�:•,Cr:t:T,.' 'n ? +n. ;..i<r a-;+p, �.�*::y;�'�:'H4'{••:,.v,:nR:.�:�,:�nd ,m � 4
-5WINI'tiivlATlflp.
' ....vi.. ,-3`..c.:2;*tfi.�. Y:.^iT.Y' ., L`•.z:iT) ,p..t.,�.- •::•,trror;t-i., .y.. ,�y.S!n.,�,*y . :h -
DESIGNERf ENGINEER Not Applicable MORTGAGE COMPANY: _Nat Applicable
Name: Name:
'Address: Address:
City: I State: City: State:
Zip: Pho e: Zip; Phone:
FEE SIMPLE TITLE HOL ER: Not Applicable BONDING COMPANY: i Not Applicable
Name' I Name:
Address: � I Address:
City: City:
Zip: Pho e: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application Is hereby made to obtain a permit to do the work and Installation as indicated.
I certify that no work or in allation has commenced prior to the issuance of a permit.
St,Lucle County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict withan` appllcabie Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult w th your Mome Owners Association and review your deed for any restrictions which may apply.
In consideration of the gra I ting of this requested:permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the ap�roved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building perrjilt applications are exempt from undergoing a full concurrency review; room additions,
accessory structures,swim-ring 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 youproperty.A Notice of Commencement must be recorded and posted on the jobsite
befor a first inspection. If you intend to obtain financing,consult with lender or an attomey before
comiftenhjng work or rRcordingypur Notice of Commenceme �•.
fir
Signature of Owner/Agen:V Lessee Signa re.sifj ontractor/license Holder
STATE OF FLORI ,A STATE OF FLO
COUNTY OF - >aC.i COUNTY OF--.
The forgoing Instrumentsacknowleclized beotysplisk, ``a.asa•k°'o,
The forgoing instrument was acknowledged before me �,•"••.
this da of 1 20byfore me= , r�{, this,day of-1 Wilt 141
A 410"V
8- z
Name f person acknowledging) g R (Name of person acknowledging) •. 6
dA
- ,� �.
Signature of Notary Pub ifc-State of Florida} >r c (Si nature of Notary Public-State of Florida} in
Personally Known OR Produced identification Personally Knowd--r ` OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission NoS✓ i1 (Seal) Commission No�CQ ' 35 fSeai}
Revised 07/1512014
REVIEWS FROM ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
i