HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t
Date: 4/18/2016 Permit Number: \GO�l 4331
RECEIV' D APR 182016
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1SS3 Fax:(772)462-1578 Commercial .. _ Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 3217 NW Perimeter Road
Legal Description: Wide Waters S/D Lot 17
PropertyTax ID#: 4436-510-0021-000-0 Lot N0.17
Site Plan Name: 1-E Block No.
Project Name: AC replacement
Setbacks Front„ Back: Right Side: Left Side:
2111EMPmr" MEN=
Replace a 1.5 ton, 14 seer AC with 5KW htr. without duct replacement in a residential building
Additional wor o orme un er t is perm —Check a app y:
✓HVAC Gas Tank []Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: S'C Ft.of First Floor;
Cost of Construction;$ 3800 utilities Sewer 11 Septic Building Height:
Name Mot lea Name: Joe Flynn'
3217 NW Perimeter Rd Company: Flynn's AC Services,Inc.
Address_ FL1323 SW Thelma St
City: Palm City State:_ Address:
34990 Fax; City: Palm City State.FL
Zip Code: 772-781-1307
Phone No. 772-283-5584 Zip Code: 34900 _ Fax:
Phone No. 772-283-4114
E-Mail: m b fl nnac,comcastbiz.net
Fill in fee simple Title Holder on next page(if different E-Mail: 1 Y
from the Owner listed above)
State or County License: CAC055482
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name'
Address: Address:
City: State: City: Stater
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 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 Iobsite
before the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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nature caner/Lessee/Agent Signat of Contractor/License Halder
STATE OF FLORIR STATE OF FLORI
COUNTY OF_ 1 V\ ^�1 COUNTY OF �1>
The for�ing instrument Wascknowledged before me The forgoing instru ent was a cnowledge+d(before me
this 1 `bday of 20 ��pby this day of 20 ! by
( me of perso ackno ledging I
(Name of pers n ackn wledgin 1
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(Signature of atary P lic 5 ate of Florida) (Si nature of Notary Pu c-State of Florida)
Personally Known�„OR Produced �a�
Personally Known OR Produced Identificati;rN Type of Identification Produced
Type of Identification Produ d O —
Commission No. el Commission No. > '�e
IoM
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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