HomeMy WebLinkAboutBuilding Permit ApplicationALt APPLICABLE rNFO MUST BE COMPTETED FOR AppLICATtON TO BE ACCEPTED
Date: 3l t-q Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7721 462-L553 Fax: (772) 462-1518 Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
PROPOSED IM PROVEM ENT LOCATI ON:
Address: 33'10 S JENKINS RD
Legal Description:
Property Tax lD #:
Site Plan Name:
2430-233-0001 -500-5 Lot No
Block No.
Project Name:
Setbacks Front Back:Right Side:Left Side:
DTTAILED DESCRIPTI.ON OF WORK:
LIKE FOR LIKE 2.5 TON 16 SEER 1O KWA/C CHANGEOUT
Idtttonal wor
Enuo.
o be oertormed under
I I eas rank
permrt -appry:Ttr
Gas Piping
S prin l<le rs
S h utte rs
Generator
[--l *,noo*s/Doors
[lrtectric r_Plumbing t-trl T Roof
Total So. Ft of Construction:Sq. Ft. of First Floor:
Utilities: f_l r"*"r. I t";;Cost of Construction: $ 3750 00 Building Height:
Name: CHRIS LANGEL
Company: SEA COAST A/C
Address: 3108 INDUSTRIAL 31 ST STREET
FORT PIERCE State: FL
Zip Code:!1946 772-466-3053
phone y1s. 772-466-2400
E-Mail:
State or County License.
OWNERILESSEE:CONTRACTOR:
113ms TIMOTHY A WORLEY Jr
Address: 3310 S JENKINS ROAD
FORT PIERCE trl5tale:' -
ZiP Code: 34981
phone Ns.772-215-4187
E-Mail:
Fill in fee simple Title Holder on next paBe ( if different
from the Owner listed above)
lf value of construction is $2500 or more, a FTECORDED Notice of Commencement is required.
CONSTRUCT]ON I N FORMATI'ON :
I certifv that no work or installation has commenced prior to the issuance of a oermit.
St. lucie County makes no representation that is grantinR a permit will authorize the permit holder to build the subiect strucrurewhich is in conflict with anV dpplicable Home Owners AsSociation rules, bvlaws or and covenants that mav restrict tjr prohibit suchstructure. Please consult With your Home Owners Association and review'your deed for any restrictions rnihich may apply.
In consideration of the granting of this requested permit, ldo hereby agree that lwill, 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
Revised 07l15l2jl4
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced ldentification
Type of ldentification Produced
Commission No.(Seal)
lmprovements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. lf you intend to obtain financing, consult with lender or an attorney bef6re
commencing work or recording Vour Notice of Commencement.
License Holder
STATE OF FLORIDA - ,
COUNTY OF 9f Lur ir
(Name of person acknowledging )
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVF
REVIEW
DATE
COMPLETE
INITIALS
NGINEER: _ Not Applicable
Add ress:
MORTGAGE COMPANY: _ Not Applicable
Name:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
7ip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Signature of Notary Public- State of Florida )
Personally Known X OR Produced ldentification
Type of ldentification Produced
Commission No.
STATE OF FLORIDA
Eiiuruw cii- -rl' Lucit
of Owner/ Lessee/Agent