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HomeMy WebLinkAboutBuilding Permit Application ( �a-ce. ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: Permit Number:ru Elmo 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: To Select from dropbox, click arrow at the end of line PROPOSED.IMePROVEMENT LOCATION:, Address: 6872 Bronte CIR Legal Description: RIVER PARK-UNIT 3-BLK 27 LOT 5(MAP 34122S)(OR 3749-613 ; 3798-251) Property Tax ID#: 3419-515-0181-000-8 Lot No. Site Plan Name: Armand A Houston Marie A Agnant Block No. Project Name: Armand A Houston Marie A Agnant Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION_OF WORK: AC CHANGE OUT 2.5TONS 14SEERS 7.5 KW FCONSTRUCTIMINFORIMATION: . Additional workto e e orme under this permit—check a appy: HVAC Ei Gas Tank E]Gas Piping _Shutters ❑Windows/Doors ❑Electric ❑ Plumbing []Sprinklers Generator Roof Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction:$ 2800.00 Utilities:n Sewer E]Septic Building Height: OMER/LESSEE: '' CONTRACTOR: Name Armand A Houston Marie A Agnant Name: RICHARD LEVINSON Address:6872 Bronte CIR Company: SERVICE AMERICA City: Port St Lucie State:FL Address: 2755 NW 63RD COURT Zip Code: 34952 Fax: City: FORT LAUDERDALE State.FL Phone No.772-486-0587 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 underg,Ing a full concurrency review: room additions, accessory structures,swimming pools,fences,walls,signs,screen roo s and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Com encement may result in your paying twice for improvements to your property. A Notice of Commen ent ust be recorded and posted on the jobsite orf a first inspection. If you intend to obtain fina ci g o sult with lender or an attorney before n in work or recordingour Notice of Comme a t. s Sign%-m df--.-6wner/Lessee. ge'nt '- Sig r of Contractor/.License:HolderJ STATE OF FLORID . STATE OF FLORI A COUNTY OF X 1,1(- LA,�_C_A COUNTY OF The fo oing instrument was acknowledged,Wore me The f°�oing instrument was acknowledged before me this day of 20 Mby this )day of 20 by (Name oLperson cknow ed ing)/ (Name of person ack owledging ) r/ , i 1 (Signature.of Notary ubliJkite of Florida) (Si6eo�1ota - a eof FloridaPerson 4yKnown Produced Identification Personally nown OR Produced Identification Type of Identifica io ype of I ntification Produced MY COMMISSIO #FF 072984 Commission No. -.: '* XPIRES: er25,2017 Commissio o„pOTSON (Sea ���� ' e Bonded ThN Notary Publ c Undervrtiters °YO<'" pAY COMrypii;EMNovember 25?2017 o? ©ondetl Thm Notary Pu n e Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS