HomeMy WebLinkAbout8501 North Blvd GeorgeALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
•
.illli�irrirlllll�l�l Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: ": F�OI
LegalDescription: LJ_A(eW01b& PCaWk
0
3t 01EDI
Property Tax ID N: lISb� - 60$ • C,199\_°_ ()M' • 4
Site Plan Name: L -C.oYOP . TCX. M-11MCG
v
Project Name:
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Setbacks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
(_l1< CAr-)L_r;t \ �
Left Side:
Lot No.i, �_
Block No. 95
Replacing A/C, exact change out, no duct work with
� v'1'_) )(2° Z-)
I - J T 0(1
121w�,cm jy S-cenC /, KW
SpJ'-t- Pr�C
SySf�mS,
CONSTRUCTION INFORMATION:
6
Additional work to be
HVAC
nertormed
under this permit -check allyapply:
Gas Tank ❑Gas Piping
LJ
Shutters
a Windows/Doors
L
11
Electric 0
Plumbing Sprinklers
1:1
Generator
Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ q,2�0� Utilities:Sewer
OSeptic
Building Height:
OWNER/LESSEE:
NameIeomt'. ba+hc.
Address: /95U / R_ l VCi
City: 17 -E- P i (- rc/e- State:F L
Zip Code: --13L_I q JJ Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Zacek, Dennis
Company: American Residential Services
Address: 2800 US Hwy 1
City: Vero Beach State: FL
Zip Code: 32960
Phone No. 772 794-7221
E -Mail: bderby@ars.com
Fax: 772 794-9783
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 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 the permit holder to build the subject structure
which is in contlict 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 Comme- cement.
2nvn,.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF Scwde
The forgoing instrument wa acknowledged before me
th is L4,dayof (YVIt-0V1 20Q911by
Dennis Zacek
(Name of person acknowledging)
�c-
nature of�tary PubState of Florida )
1
Signature of Cont or/License Holder
STATE OF FLORIDA
COUNTY OF St Lucie
The forgoing instrument was acknowledged before me
this Aday offfVaV__d-A .20 ALOby
Dennis Zacek
(Name of person acknowledging
)
(Sigi�aCure of Notary llblic-taiite of lorida )
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produc ...
ETH A DERBY
Commission No. FFzzasao 1:,{�5t�.:•_ (Sea43ETH A DERBY Co mission No. rF22osao ? : •'0 M�B�1}v1MISSION # FF220 : )
MY COMMISSION # FF22 )930 .;srarM1,:' EXPIRES April 15, 2019
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'/- iS7/.'Ikf� ice, cu rn 1 - •rv�emre cmr
Revised 07/15/2014 I nWita9-015] florbaNc!.,Sc cecm J p V
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS