HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7728710863 p.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f
Date: Permit Number: /Yr " naln
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 xxxxxxx
PERMIT APPLICATION FOR: Mechanical El
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ESR ED:�MP .: . -
OS 1100
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Address: 10 Violetta Lane
Legal Description:
Property Tax ID#: id# 718D20049973 Lot No.
Site Plan Name: Block No.
Project Name: Jon Gaillard
Setbacks Front Back: Right Side: Left Side:
Like for Like AIC Package Unit Replacemtent 4 Ton-10kw-14 Seer-Ground
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Ac1clitional work to be pertormed under this permit–checK a appy:
RHVAC 1-1 Gas Tank ❑Gas Piping 1 Shutters a Windows/Doors
11 Electric 1_I Plumbing Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 5252.55 Utilities: Sewer Septic Building Height:
_
Name Jon Gaillard Name: Don Miranda
Address:10 Violetta Lane Company: Miranda Plumbing &Air Conditioning, Inc,
City: Port St Lucie State:FL Address: 750 NW Enterprise Drive
Zip Code: 34952 Fax: City: Port St Lucie State:FL
Phone No.772-878-9828 Zip Code: 34986 Fax: 772-871-0863
E-Mail:Jongaillard@comcast.net Phone No, 772-878-5123
Fill in fee simple Title Holder on next page (if different E-Mail: Ldiodato@mirandacompanies.com
from the Owner listed above) State or County License: CAC1815486
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Miranda Plumbing&AC 7728710863 p.2
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DESIGNER/ENGINEER _tNot Applicable MORTGAGE COMPANY:' Not Applicable
Name: Name:
'Address:_ Ad d cess:
City: State. City: State:
Zip: Pho e' Zip: Phone:
FEE SIMPLE TITLE HOL ER: _Not Applicable BONDING COMPANY: _ ,Not Applicable
Name: ( 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 certifythat no work or installation has commenced priorto 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 with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consultw th your Home Owners Association and review your deed for any restrictions which may apply.
in consideration of the grai iting 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 pe it applications are exempt from undergoinga.full concurrency review;room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-resldential use
WARNING TO OWNEII: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
befor a first Inspection.If you intend to obtain financing,consult with lender or an attorney before
corprhenWng work or recordin our Notice of Commenceme
Signature of Owner/Age 1/Lessee Signa re3f ontractor/License Holder
STATE OF FLORjJ?Aj STATE OF FLO
COUNTY OF vC. COUNTY OF .I--yC'� .
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The forgoing instrument as acknowled ed before me�..iy�:yo�,,, The forgoing instrument was acknowledged before me °�,'� ��.°l',
this day of 20�by 7 this_day of _ .2010•by
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Name f person acknowledging) y m (Name cf person acknowledging) z la
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fFR /ji �/!1� c o Ctl
Signature of Notary Pub ic-State of Florida) � �8 c (Si nature of Notary Public-State of Florida) M
Personally Known OR Produced Identification Personally Known -----'OR Produced Identification
Type of Identification Prod uced Type of Identification Produced
Commission No.tEr< �� (Seal) Commission No ff7�l�ay35-"(Seal)
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Revised 07115/2014
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