HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:���`� Permit Number:
. RECE.IV'-'D PEAR 2 9 2016
Building Permit Application
Planning and Development Seryices
Building and Code Regulation Division
2300 Virginia Avenue,Fart Pierce FL 34952
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FGR: To Select from dropbox, click arrow at the end of line
Address: 9116 SHORT CHIP CIR
Legal Description: LAKES AT PGA VILLAGE(PB 43-32)SLK D LOT 60(OR 3802-2768)
Property Tax lD#t: 3334-501-0198-000-7 Lot No.60
Site Plan Name: BELINDA PIZARRO Block No. D
Project Name:
Setbacks Front Back: Right Side: Left Side:
LIKE FOR LIKE AIC CHANGEOUT BT/14S RUUD 10 KW
Additiona I work to berformecl unclerthis permi —c ec all apply:
QHVAC Gas Tank 11as Piping _Shutters Windows/Doors
[]Electric n-Plumbing [Sprinklers 11Generator EIRoof
Total Sq. Ft of Construction: SQ.Ft.of First Floor:
Cost of Construction:$ 4881.00 Utilities:7Sewer F]Septic Building Height:
Name BELINDA PIZARRO Name: JAMES DEGATINA
Address:9116 SHORT CHIP CIR Company: ALL AMERICAN AIR&ELECTRIC
City PORT ST LUCIE State:FL Address: 611 NW MERCANTILE PLACE
Zip Code: 34986 Fax; City: PORT ST LUCIE State:Fl-
Phone
LPhone No.609-254-2567 Zip Code: 34986 Fax: 772-878-5144
E-Mail: Phone No. 772-878-5143
Fill in fee simple Title Holder on next page(if different E-Mail. GRUF@AAAEINC.COM
from the Owner listed above) State or County License: CAC057905
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:,
City: State.— City- State:
ZIP: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY. 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 Coun 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 plan.s,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:roam additions,
accessory structures,swimming pools,fences,wells,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.
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S4%99ZMM255w_Aer/Lessee/Agent Signatu raap—r/Lidense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ISANT LUCIE COUNTY OF sAl-Lume
The for Ing instrument w4sacknowledged before me The forgoing instrument was acknowledged before me
this W 20 lXby this2rdayaf WD.1221 20 )1,1—by
day of
JAMES PgQA-nNA JAMES DEGNmA
me of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public4tVio-of Florida) -signature of Notary Pi thlir-State o rida
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of identification Produced Type of identification Produced
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Revised 0711512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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