HomeMy WebLinkAboutbuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
_ 3 .
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: of
Legal Description:
Property Tax ID ti: Lot No.
Site Plan Name:` Block No.
Project Name: S'
Setbacks Front Back: Right Side: Left Side:
Replacing A/C, exact change out, no duct work with `k %On Carr, c Y- [1 S- --e-Y-
I � �v� S�,, WC 5454 ern
HVAC Li Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction.
r~
Cost of Construction: $ t
unser anis permit —
as Piping
Sprinklers
Shutters Q Windows/Doors
Generator Roof
SFt. of First Floor: _
UtiIities:2 Sewer []Sept ic
OWNER/LESSEE: I GONTRACTO.R:
Name
o-ar o► u
Address: (D50
C-�C_
City:
Stat
Zip Code:
�cti Fax
Phone No.
E -Mail:
Fill In fee simple Title Holder on next page ( if different
from the owner listed above)
Building Height:
Name: Zacek, Dennis
Company: American Residential Services
Address: 2800 US Hwy 1
City: Vero Beach State: FL
Zip Code: 32960 Fax: 772 794-9783
Phone No. 772 794-7221
E -Mail: bderby@ars.com
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 App
Name:
Address:
City: State.,
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: X Not Applicable
Name:
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 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
commencine work or recordine your Notice of Commencement.
�_ I .� �% I t 2 �_ s
_ Signature of Ow r/ Lessee/Agent Signature of Contor/License Holder
STATE OF FLORIDA
COUNTY OF St. I-@
STATE OF FLORIDA
COUNTY OF SIL...
The forgoing instrument was acknowledged before meI The forgoing instrument was acknowledged before me
this day of i�yCt ZO by this � day of 9�`f `� s`.�' '; 20 by
Dennis Zecek Dennis Zacek
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notaryublia State ofs ;lorida } (Sigria ure of Notary PubIc- State of Fl a }
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. FF2 s3Q1%. '..,, BEi%aA DERBY Commission No. FF22o310' •, B970A DERBY
'� a_ MY COMMISSION # FF220930
�•= MY COMMISSION # FF224930
Revised 41C7. '4;"�3 rlontiallowySe^nee%m
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS