HomeMy WebLinkAboutBuilding Permit Application ALL 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 34982 -
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X-
PERMIT APPLICATION FOR: -
Mechanical
PROPOSED IMPROVEMtNtLOCAT,ION t� v.
Address: 1� tY1 r jre, �.'I-Q,
Legal Description:
Property Tax ID#: - -S. 0.C)0Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks "Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:"
_-ONSTRUCTION INFORMATION
Additional work to be nertormed under tis permit—check all that appy:
Z✓ HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
0Electric 0 Plumbing--" Sprinklers ' Generator Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 3d . ,' Utilities:Sewer Septic Building Height:
OWNER/LESSE� - CONTRACTOR: >'`' '
Name r11 n "` S Name: James J Waiters
> .
Address:_ r�� I pczl,e6 Psr»s r Company: Justlhillin',HVAG`LLC;
City: F6,ci •Pre rrP State:FL Address: 5422 NW Croriie"y,St
Zip Code: 3 1 Fax- City: Port St. Lucie" State:FL
Phone No. 'h2,"51 q'O 1'7 2. Zip Code: 34986 Fax:
E-Mail: Phone No. 772-940-4373
Fill in fee simple Title Holder on next page(if different E-Mail justchillinair@hotmail.com
from the Owner listed above) State or County License:'26326
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 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.
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 our Notice of Commencement.
Si nature of Owner/Agent/Lessee Sighature of ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA f
COUNTY OF G L� COUNTY OF
The or oing instru ent was acknowledge before me The f , oing instr merit was acknowledged before me
this day of 20 by this day of d \ 20jGby
(N4e of person acknowledging) (Name of erson acknowledging) .
Ger'
(Si a of Nota ub ic-State of Florida) ( g t' „ \Xd Co yli�r Fcqof Florida)
�oa`o.
erso *( , rQMT Produced Identification ersona owg'�yC Pap tification
Type of Identi �' '�I'd
Type: :.; otarhy Public, HUFF a hr°Ggh�ahr�s�a1 34j30 da.
Co i CoFFa of � a Commission No. ?Or9 eal)
Bondedmm.Expire". 23gy3t) ygssn
throo �ay 2
aUn Not�YAssn. '
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE. MANGROVE
COUNTER REVIEW REVIEW REVIEW 'REVIEW' REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED