HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE.COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11I JI I Permit Number: 1 �1' 0091
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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 �✓
PERMIT APPLICATION FOR: Mechanical
PROPOSED INPROVEMENT LOCATION
r
Address: 00 L P
Legal Description: FV 6Lr+XX'f r—1 o'e,
(An c - 3
Property Tax I D#: 44,9 L D_ �—5r- 01015 P CQ12 IQ
Lot No.
Site Plan Name: Block No.
Project Name: Mu
Setbacks Front ack: Right Side: Left Side:
DETAILED.DESCRIPTION OF,WORK
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G l �J c+k 5 tc:�Lo
CONSTRUCTION INFORMATION:
itiona wor to e e orme under this permit- .e
c c a appy:
HVAC Fi Gas Tank DGas Piping _Shutters Windows/Doors
11Electric 0 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: ac:�5( Sq. Ft.of First Floor:
Cost of Construction:$rj.'�375.C)d Utilities: Sewer ElSeptic Building Height:
OWNER/LESSEE i CONTRACTOR
Name VC 3 Name: MICHAEL EWING
Address:_i 5cs �.QnC�� `I Company: PIONEER COOLING&HEATING
City:__PQayvi " State:FIL Address: 585 NW MERCANTILE PLACE#106
Zip Code:3"Q 0 Fax: City: PORT ST LUCIE State:FL
Phone No.('-7-1A_ (o�( � RM 53 Zip Code: 34986 Fax:
E-Mail: Phone No. 772-W
Fill in fee simple Title Holder on next page(if different E-Mail: pioneerheatingco@bellsouth.net
from the Owner listed above) State or County License: CAG1817251
if value of construction is$2500-or more,a RECORDED Notice of Commencement is required.
I ' � r t s
SyU,LfEN�LAUU INFORN�AT�ON
v:
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:
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 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 holderto 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 1 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 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/ ent/Lessee ignature of Contractor/Li ense Holder
STATE OF FL A STATE OF FLORID
COUNTY OF COUNTY OF . ULOA Ie—
The forgoing instr merit was acknowled ed before me The forgoing instrument was acknowledged before me
this day of. 20La by this�day of Q ti 20®by
AeA Y l.ce l C_�
(Name of person acknowledging) (Name of person acknowledging)
(Signature'of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known Produced Identification Personally Known OR Produced.Identification
Type,of Identification Produced Type of Identification Produced
Commission No. 'MIA, t%BdPAH RUSSELL Commission No. Edi
Notary Public-State of Florida ,.�Ta���a,, DE ORA RUSSELLH w
• * 30 2018 �2°. . : Notary Public-State of Florida
r° - *o;; commission #FF 179630 ?N w * y omm. xpires Nov 30,2018
Revised 07/15/20 'n;o„;°` Bonded through National Nolary Assn. ' ,F °�°•' Commission#FF 179630
Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED