HomeMy WebLinkAbout222 NE Mainsail St KuchlingALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34.982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOS�O.IMPROVEMENT LOCATION'
Address:
Legal Descriptions :v Qo,rk— ' h� �` ` �,a rA-C fj'\k `60 - �-- IZ
Property Tax ID ##: 3LA1G - E;10 - cod%. ( 3 Lot No.
Site Plan Name: _JLC, + `l 1 -.. J-"f''k -_ Block No.
Project Name: \_ XV) IT
Yl i K-6 _
Setbacks Front Back: Right Side: Left Side:
Q13TAI �,.I] CRIPTI.ON OF WORK:
Replacing A/C, exact change out, no duct work with � c . 5 -Ton
I ke S-t'..rx --I V"\"J Sp1. -\ (\
CO.NSTRUCTION INFORMATION:
Additional work to be ertormed under this permit — check all apply: r
HVAC 11GasTank Das Piping _Shutters ❑Windows/Qoars11 L�
Electric 0 Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $,n Utilities t Sewer ElSeptic Building Height:
OWNER/LE55F CONTRACOR:
Name 1C�.x Gi t Y�- 'I_r1 __ Name: Zacek, Dennis
Address Company: American Residential Services
City: - .v ,ti_ -P State: Address: 2800 US Hwy 1
Zip Code: -!:�6q '63 Fax: City: Vero Beach State: FL
Phone No. Zip Code: 32960 Fax: 772 794-9783
E -Mail: Phone No. 772 794-7221
Fill in fee simple Title Holder on next page ( If different E -Mail: bderby@ars.com
from the Owner listed above) State or County License: CMC1249753
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x Nat 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 thepermit 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 your Notice of Commencement.
_ Signature of Ow r/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF SLLueie
Signature of Cont2 or/License Holder
STATE OF FLORIDA
COUNTY OF sawn @
The forgoing instrument was a knowled before me The forgoing instrument was a'knowledgUby
fore me
this day of n t} t . 20\ by this day of �^ �I-C'A,- , 20
Dennis Zacek Dennis Zaeek
(Name of person acknowledging } (Name of person acknowledging }
(Sig re of Notary Public- State of lorida } - (S ture Aoffa'i ublic- Stat Fforida }
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produ ..... _, r%ny Type of identification Produced
ME a FF22os30 ;�•:. BETH A DERBY
Commission No. FF220930 '+4 M•( ISSION ommission No. FF220930
%r E� Aril 15 2019 Iu�1�i�1MISSION q FF209"
EXPIRES P
,y''""``', Fl Y,daNn'�„��.,,,r►ccrr �'':raggw . EXPIRES April 1S 1019
14n) 1 i�-U 73 rwnan,..r
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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