HomeMy WebLinkAboutBuilding Permit Application 02/1812016 15:16 JAX) P.0021003
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r"
Date: 2-18-16 - --_ _._.. Permit Number: /(0-0 a • 0
two VE[D
Building Permit Application ..FEB � � 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virglnla Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578. Commercial Residential XXX
PERMIT APPLICATION FOR: To Select from dropbox,'click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 8324 Belfry Place
Legal Description: POD 28 at The Reserve Lot 7(OR1698-1090:2823-1958)
Property Tax ID#: 3327-701-0010-000-8 Lot No.7
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
HVAC change out only- 16seer 3.5ton 10kw heat kit.
CONSTRUCTION INFORMATION:
AWItional worK to De•vertormed un er is'permi -check all appy:
HVAC Gas Tank Gas Piping _Shutters I__t W.indows/Doors
Electric 0 Plumbing ❑Sprinklers Generator; Roof
Total Sq,Ft of Construction: Sq.Ft.of.First Floor:
Cost of Construction:$ Utilities:U Sewer O Septic, Building Height:
OWN ER%LESSEE: CONTRACTOR:
Name Duane A Muttl Name: Scott Camlre
Address:57 Crooked Tri Company: AC Advantagelnc
City: Rowayton State:CT Address: 1926 SUV Blitmore St
Zip Code: 06853 Fax: City: port 5t Lucie State*FL
Phone No. Zip Code: 34984 Fax: 772-3$8-7566 .
E-Mail; Phone No, 772-336-7366
Fill In fee simple Title Holder on next page(If different E-Mail: csr@acadvantageinc.com
from the owner listed above) State or County License:.CMC1249807 -_--
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
0211812016 15:32 (FAX) P.0011001
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFOR•MATIOM
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.
$t.L(tcie'Coun makfl�no.repres�n�ation that is granting a ermit will au�h�rize the germtt holder to build the subjects crura
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may res$trict or prohI It such
structure.Please consult with your Nome 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 Florlda Building Codes and 5t.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 lobsite
before the first inspection.-If you intend to obtain financing,consult . h lender or an attorney before
coMmencirig work or recording vour Notice of Commencement.
. • s
_Sign urs of Owner/ see/Agent Signatur of Contractor/License Molder
STATE OF FLORIDA STATE OF FLORIDA .
COUNTY OF at Ludy COUNTY OF atLuai
Theorgoing ins Cgent was acknowledged before me The forgoing instrum nt was acknowledgel before me
this day of 201L�by this,V,day of 20 by
Scott Camlre Scott CONN
(Name of person ackaQwledging (Name of person abkno le ging
(S' nature f Notarpublic- ate•of Florida•) (Slgnatu gof Notary Pu llc-State of Florida)
Pe Known XXX OR Produced Identification ' • Personally Known xxx ' OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF172252 d 1iP u, Commission No. FF172202 (seal)
AskNOTARY PUBUc Jwnl0 Pew
.5TATE OF ORIDA STATE OF FIARIDA
Revised 07/15/2014 Conxr FP17ZZ82 C TowFF172M
Expires 10/98/2018 %?OXF116-A^,-- 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS ,