HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABft.000fiVILIST BE COMPLETED FOR..APPLICATION TO.BE ACCEPTED ��r�
Date: Permit Number: . I
Building Permit-Application
Planning and Development Services
Building and Code Regulotion.bivision
2300 Virginia Avenue,Fort Pierce FL 34982
Phones(772).462-1553 Fax:(772)462=1578 Commercial Residential V.
PERMIT APPLICATION. FOR; Mechanical -
PROPOSED
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Address: 4::;L'1C1 l_0_QJ0 X7t Ci
Legal_Description: Cl-1Uyo
Property Tax I D#:� y' — 1,f`,�, - �, �
Lqt No..
Site Plain Name: Block':No: .k'1
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Project Name: infYQ>. n.
Setbacks Front Back: Right Side: Left,Side:
DETAILED DESCRlPTI0h10'F WO'RKJ4' r i
reptac� cy__ a
'CON5TRUCTIl7N4INFORMATION `
UHit na wor :to e e Orme . un ert ispermit—c ec a appy:
VAC 1]:Gas. Ta.nk []Gas..Piping Shutters a Windows/Boors-
aElectric Q.Plumb ng F inklers Generator Roof
-Total Sq.Ft of Construction: ` �\;--A S(3-Ft'
-Ft.of First Floor:. .
Cost of Construction:$. �, .Jt"Y�7 Utilities: Sewer aseptic Building Height:
OWNER/GESSE � f: r >. CONTRACTOR pry ,
TODD DEJARNETTE
Name � Name::. -
Address: CJ� ompany: GXAIR:CONDITIONING.
City. _ State:Ft- Address: 1401 SW MEDINA AVE
Zip Code:;-R�� Fax: ---+ City: PORT ST.LUCIE State:FL
Phone No. Zip.Code: 34953 Fax:
E-Mail: Phone-No. 772-344-5520
Fill in fee simple Title:Holder on:next page(if different E-Mail: gxairheat@yahoo.com
from the Owner listed above) State-or County License: CAC1814467
if value of construction is$2500 or.more,a RECORDED Notice of-Commencement is required:
F T i 2 1 :
SUI�PLEM�NTLSCONSTR�ICTION`t,IEN'LAW IN1=0RMAT14N
LW=$ 4fi. '' .,.a�.;,v,Yro4�.'.` nr :.SYf.•§ .'. n+. ; R
DESIGNER/ENGINEER ._NMORTGAGE-COMPANY:
E _ Y..• w F. w
of Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address; Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEESIMPLE TITLE HOLDER: Not Applicable BONDING.'COMPANY: Not Applicable
Name: Name:
Address: Address:
City: - ..City.
Zip: Phone: Zip: Phone:
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 ermitwill authorize 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:.Pleaseconsult 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 twill;in all.respects,perform.the work
in accordance with the approved.plans;the Florida Building'Codes andSt.Lucie County:Amendments..
The following building permit applications are exempt from undergoiing a full concurrency review:room.additions
accessory structuress 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 jobsite
before the first.inspection. If.you.intend to.obtain,financing, consult with.lender or an attorney before
-commencing work or recording.Vour Notice.of Commencement.
C_
r e. .
ignatureofOwnerJAge /Lessee Signatureof.Contractor icense.Holder
STATE OF FLORIDA STATE,OF FLORIDA ,
COUNTY OF L1 r.� COUNTYOF'.
The forgoing instrum nt was a knowledged before me The forgoing instrument was acknowledged before me
this day of _; zo.1�3by this '1'�'ay pf Y�'l� h 20_JAQby
(Name of person acknowledging) (Name of person acknowledgin
(Signature of Notary.Public- a of Florida:) ASIgnature of:Notary Publics:State ofTlorida)
Personally Known OR Produced Identification Personally.Known r OR Produced Identification
:ten .
Type of Identificatio P oduced Type of Identifica t6n PrQ—)AGed'-2-�
,.���RY�G' p ?2�, +`�= Notary R SSELL
Commission'No: o o' $a{)fi RUSSELL
Commission No. =. * y Y Publi a of Florida
*�: Notary Public-State of Florida a § Y Comm.Expires Nov 30,
°* 2018
My Comm.Ex ire '4FOFFlO�O•, Commissio
ommission #FF 179630 en ed through National Notar
oFF�o YAssn.
""""' Bonded throw
Revised 07/15/20i.- . 9h National Notary Assn.
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