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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED.FOR APPLICATION TO BE ACCEPTED Date: l�'�` Permit Number: RECEWED NOV 0 61015 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 IM,PROVEM,ENT„LOCATION , Address: V I Legal Description: p `on Property Tax ID#: 5t"b (�)©56, Lot Nox__�_ Site Plan Name: Block No. Project Name: r-l�ii' sayla Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION ne f lake r -,--I- a -tom A) ! ATAC CONM .,"T N'.- Aciditional work to be nertormed under t is permit-check all appy: VAC Gas Tank Etas Piping _Shutters E]Windows/Doors DElectric ElPlumbing OSprinklers Generator F]Roof Total Sq. Ft of Construction: �3 Lo!— S .Ft.of First Floor: � Cost of Construction:$ q�.E D Utilities"t Sewer ElSeptic Building Height- "ER/ .CONTRACTOR Name Name; TODD DEJARNETTE Address; I R4 Mt9nnOni+e U Company: GX AIR CONDITIONING City: Stater Address: 1401 SW MEDINA AVE Zip Code:1 C,o Fax: . �— City: PORT ST..LUCIE State:FL Phone No.L-p L l0 5Lo Q 41� o� 11 Zip Code: 34953 Fax: E-Mail: - Phone No. 772-344-5520 Fill in fee simple Title Holder on next page(if different E-Mail: 9xairheat@yahoo.com from the Owner listed above) State or County License: CAC1814487 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CO3[V5TRUCTION LIEN LAIN INFO.RIVIATION 4 r 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 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. ignature of Owner/Ageq/Lessee Signature of Contractor/ icense Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF !E+- . La.¢Gc COUNTY OF - The forgoing instr ment was acknowledged before me The forgoing instrument was acknowledged before me this L&day of e++ w 20 Eby this Z•4,clay of hBL _. .2012 by (Name of person acknowl ing) (Name of person ackn ledging) (Signature of Notary Pub' -State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known `' OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. Commission No. H RUSSELL •,�u a n�4 .•N"y T77", •��tPnrn�a,,c DEBORAH RUSSELL ;•_*» „*� Notary Public-State of Florida — w =My Comm.Expires Nov 30,20184 3".' °o;: Commission# FF 179630 Revised 07/157 ' Commission #FF 179630 j °;;° • Bonded through National Notary Assn. Bonded through National Notary Acca. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS