HomeMy WebLinkAboutBuilding Permit Application 1110:k015 10:46 TAX) P.0011003
ALL APPLICABLE INFO MUST BE COMPLBTBD FOR APPLICATION TO BE ACCEPTED
Date: 10-27-15 PermitNumber:
Building Permit Application
Planning and Development Services
Building and Code Regulation,Division
2300 Virginla Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 -Fax:(772)462-1578 Commercial . Residential. .
PERMIT APPLICATION FOR: Mechanical
.PROPOSED I-MPROVEMENT•LOCATION:
Address: 4 Don Quixote Lane Port St Lucie 34952
Legal Description:
PropertyTax ID#: 3424-711-000-2-000-5 _ Lot No.
(Site Plan Name: Block No.
Project Name:_ -------__-----. _--
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC change out only, 14 seer 3.5ton RULID pkg unit 10kw
CONSTRUCTION INFORMATION:
Additionalwork oorme under this permit—c ec a appy:
[MVAC �Gas Tank ' 0Gas Piping _Shutters 0-Windows/Doors
Electric E Plumbing Sprinklers 1:1 Generator, O Roof•
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
'Cost of Construction:•$ 4025.' Utilities:0Sewer Septi c. Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Robert Labode Name: Scott Camlre.
Address:4 Don Quixote Lane Company' AC Advantage Inc
City: Part St Lucie State;F1 Address; 1926 SW Biltmore St
Zip Code; 34952 Fax; City: Part St Lucie State:.Fl -
Phone No.413-347-0331 zip Code: 34984 Fax. 772-336-7566
E-Mail: Phone No. 772`336-7366
Fill in fee simple Title Holder on next page(If different E-Mail: csr@acadvantageinc.corn
from the Owner listed above) State or County License: CMC1249807
if value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
1110312015 10:46 (FAX) P.0021003
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:
certify that no work or installation has commenced•prioc•to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize theLoermlt holder to build the subject structure
which is in conflict with an applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult w.th 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.Lucle 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 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,cons It with lender or an attorney before
commepicing work or recordina vour Notice of Commencement.
t.Sl nature of Owner/Lessee/Agent Sign ture of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFstwo. —--- . . .. . - - --... ........_.._... _ COUNTY OF stt.U*la
Theforgoing Instrument was acknowledged'before me The forgoing'Iristrument was acknowledged before me
this 2_"t day of V�*- 20 Eby this z . day of O01 ----x'20• by
Scott Camke 'Scott Canilre .
.(Name of person ackno a ing) (Name of.person acknowledging)
(Slgnat're of Notary P bllc=State of Florida) (Signatur of )tary Public-Stat of Florida)
Personally Known.xx OR Produced-Identification Personally Known xx ' OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. PF17226 (SeyAk Pm a Commission No, FF172262 (Sed
Parra
NOTARY PUBLIC NOTARY PUBLIC
STATE OF FLORIDA
Revised 07/15/2014 OWWA FF172 • Cowng FP17E
Tres 10 {rea 10128/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW RE%AEW
DATE
COMPLETE
INITIALS