HomeMy WebLinkAboutBuilding Permit Application Dec 14 2015 8:42AM HP Fax page 2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12.14.2015 Permit Number:
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
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Address: 401 Paurotis Lane,Fort Pierce, FL 34982
Legal Description: PALM GROVE SID BLK J LOT 7 (0. 13AC)(OR 934-2143)
Property Tax ID#:3410-503-0259-000-2 Lot I jo.7
Site Plan Name: PALM GROVE Block No.J
Project Name:
Setbacks Front Back: Right Side: Left Side:
NMI
Remove 2.5 ton air conditioning system with 5kw heat, for New like Goodman 14 seer 2.5 ton split
system air conditioner with 5 kw heat.
WAUalf0lonlawWaINQW orme un erx ispermi —c ec a appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Do rs
Electric 0 Plumbing OSprinklers Generator Roof
Total Sq.Ft of Construction: 1899 .Ft:of First Floor: 1305
Cost of Construction:$ 1800.00 UtilitiesSewer USeptic . Building Heigh
NamePaldcia Garyon Name: Robert Hennis
Address:401 Paurotis Lane _ Company: Air Control Air Conditioning and Re igeration,LLC
City: Fort Pierce State: FL Address: 5415 Silver Oak Drive
Zip Code: 34982 Fax: City: Fort Pierce tate:FL
Phone No.772-466-9598 Zip Code: 34982 Fax::772-46 -6613
E-Mail: Phone No. 772-460-2665.
Fill in fee simple Title Holder on next page(if different E-Mail: aircontrolac@yahoo.com
from the.Owner listed above) State or County License: Cac1815015
If value of construction is$2500 or more,-a RECORDED Notice of Commencement Is required.
Dec 14 2015 8:43AM HP Fax page 3
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DESIGNER/ENGINEER: —Not Applicable P 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: Pholl
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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anscovenants 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.
c.ommencing wok or recording our Notice of Commencement.
G�/!%✓/
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_Signature of Owner/Lessee Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT Ill COUNTY OF SAINTLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged be ore me
this iqti day ol�,ol . 20 1Wby this 14 day of December 20 y
WILLIAM PALLADIll WILLIAM PALLADINO
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida i
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. EE 208516 * :' *) WILM MY bNlEE f6 Commission No. EE206516 Se
,y IWAAM
E1(PIHES:Jane 14,261 * *
My
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anEXPIRES;ions wims;
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS