HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3115/2016 Permit Number:
J
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 IMPROVEMENT LOCATION:
Address: 556 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0742-000-4
Property Tax ID ##:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
Change out 2 112 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
7
iditional work to be nertormed
Gas Tank
unaertnis permit—cnecK ailapply:
❑Gas Piping
M_ Shutters
❑ Windows/Doors
HVAC
Address: 1296 SE Industrial Blvd
City: fort St Lucie State: A
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
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11 Electric ❑ Plumbing
❑ Sprinklers
❑ Generator
❑ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 3300.00
SFt. of First Floor:
Utilities: Sewer 11 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William Crowley
Address: 556 Nettles Blvd
Name: Vance R Corbin
Company: Dodd Enterprises Inc
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No. 781-871-5445
Address: 1296 SE Industrial Blvd
City: fort St Lucie State: A
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: doddenterprises@dodd.com
State or County License: CMC1249958
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
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
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 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 Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF LtL i. COUNTY OF ls�
r
The forgoing instrume t was acknowledged before me The forgoing instrument was acknowledged before me
this l day of_ ,i, ,Lrx , 20 -4by this t\ day of i , ^+ 201 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Nota Public- State of Floridan (Signature of Nota Public- State of Florida)
Personally -Known � OR Produced Identification Personally Known � OR Produced lderr�ficat ori s= "
Ty#e ofid"en-titcation Produced Type of Identification Produced - -
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REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS