HomeMy WebLinkAboutBuilding Permit Application 0212312016 11:26 (Fa P.0021003
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / _
Date: Permit Number: t lG U 7
RECEMED
Building Permit Application FEB 2 3 2016
Planning and Development Services 'PER HITTING
Building and Code Regulation Division• St. Lucie.County, FL .
2300 Vlrglnla Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 24 Golf Dr Port St Lucie 34952
Legal Description:. _
Property Tax ID'#: 31lq Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front____._ Hack: - Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
HVAC change out only Lennox 14 seer 2.5 ton pkg unit 7..5kw
CONSTRUCTION INFORMATION:
Additional work o be partormecl under this perms —check a appy:
✓HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
J]Electric 11Plumbing ❑Sprinklers E l denerator • I..�1 Roof
Total Sq.Ft of Construction: S . Ft,of Flrst Floor:
Cost of Construction:$ �6 Utilities: Sewer Septic Building Height:
OWNER/LESSEE.- CONTRAItTOR:
Name Arlene Dale Name: Scott Camlre
Address:24 Golf Or Company. AC Advantage Inc
City: Port St Lucie State:51 Address: 1926 SW Biltmore St
Zip Code:_34952 fax, City: Port St Lucie State:Fl
Phone No.. �, . L><� 7 i'O q(P2 Zip Code: 349$4 Fax: 772-336-7566
E-Mail: Phone No. 772-336-7366
Fill In fee simple Title Holder on next page(if different E-Mail: csr@acadventageinc.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.
0212312016 11:27 (FAS) P.0031003
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: —_—__--_ Name:
Address: Address:
City: State: City: State:
Zip: _ Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: 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 out�torize the permit holder to build the subject grt�cture
which is in conflict with an pplicable Home Owners Association rules,by aws or an covenants that may restrict or pro I It 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 pians,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,consul with lender or an attorney before
commencipt work or recording your Notice of Commencement.
s
Sidnotgre of Owner/Lessee/Agent Signa elbf Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF smudv COUNTY OF StUds
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 23 day of Rt-� 201&o by this 23 day of Pc--b 20 1S9 by
Boott Cedre Scott Camirn
(Name of person ackno ledging) (Name of person acknowledgi g)
( Ignat re o Nota Public-State of Florida) (Ona )f Notary Publ1 I
State of Florida)
Personally Known xxx OR Produced Identification Personally Known xxx OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF1722$2a C0 Pe= Commission No. FFIM$2 J04k#"
STATR OF FtompA
AFtY PtJgLIC NOTARY PUBLtC
• FF172289 . CotterFFJr'=
Revised 07/15/2014 EVIM 1Q1�a 2pgs I 100=18
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS