HomeMy WebLinkAboutBuilding Permit Application From:Air Repair Solutions,[Fax:(800)757-0066 To: Fax: +1(772)462-1578 Page 2 of 6 02/16/2016 2:41 PM
ALL APPLICP.BLE JNFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. Permit Number:-
Building Permit Application FEB 16 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
y a Ji'
?RCtPQ �I11/I�RIENIINTCJTI s
Address: tC� �oJ
Legal Description: LaiK (' ti
PropertyTax'ID#: 1301 tbk� (-2itt000 1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks' Front Back: Right Side: Left Side:
01
f IF �� � LiF IIT`I:ON"COR 1�'.{+..� C NO
'[�'S �,t:�l��;• `�,�'1C�C's��.' �:?'�` �E�,�:.a C �1�.�.. ���g0...�` � --T CY7l �.,�Ybe''tOZC ���^
ge-
Ir
Etiana wor to e e Orme un er t �s}permit-c ec a app y:
HVAC �Gas Tank ❑Gas Piping Shutters �Windows/Doors
Electric ❑Plumbing �Sprinkiers �Generator �Roof
Total Sq.Ft of Construction: SFt.of First
(Floor:
Cost of Construction:$ q }U� Utilities: Sewer L Septic Building Height:
OVUERLESEmwwy
4 S { CUtTRACT GY ]
Name a Name:
Address-UELL �Q iblf?S •,t� Company: -i r, t° e€ AA
City t Cly State: Address:. L
2ffi. FN . 17
Zip Coderssl Fax: City- }r- 71mirc State V=(-
Phone No-1-1;i� . z (31cgo Zip Code: LIQ% Fax 1'�) 13,W--am-
E-Mail: Phone No."7"1:) (ori Q-0
Fill in fee simple Title Holder-on next page(if different E-Mail:0..6.r (' CO F/_C;6 Eg4m-- 12 ' t:L0
from the Owner listed above) State or County License: tC"�
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
From:Air Repair Solutions,IFax:(800)767-0066
To: Fax: +1(772)462-1578 Page 3 of 3 0211712016x3:03 AM
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lDESIGNERANGINEER: 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: Marne:
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 re ordin our Notice of Commencement.
�.
Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORI � �
COUNTY OF +-LU U-e, COUNTY OF t )CA E-'
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-�day of— eJ0,Ctj0,,AC" 20 {�by this K O day of .20 by
(Name of person acknowledging) (Mame of person acknowledging)
{Signatu Notary Public-State of Florida} (Signatur a Notary Public-State of Florida}
Personally Known 110 OR Produced identification Personally Known Q OR Produced Identification
Type of Identification Produced o ='. HO LYNCOLEKULINSKI Type of Identification Produced HOLLY N100E KULINSKt
MY COMMISSION 4 FF 142732 ,� *MY COM9, FF 142132S
* ES:August 5,2018
Commission No. ` 'lis �{SeWIRES:August'5,2018 Commission No. �� 4�at fPorded uwoNobyServim
�rps�F4oa`O 0Nad9dTf�uBt�dgztNataryServicesapF�n
Revised 0711512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS1771'