HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/27/16 Permit Number:
t
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 10316 CROSBY PLACE
Legal Description:
Property Tax ID #: 3327-709-0042-000-5
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE CHANGEOUT
2 TON 17 SEER 5 KW HEAT PUMP
CONSTRUCTION INFORMATION:
Additional work to b
jjrformed under
❑✓ HVAC LT1 Gas Tank
11 Electric ❑ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 6478.00
Commercial Residential X
Right Side:
Left Side:
mispermit— cnecicaii apply:
[]Gas Piping Shutters
Sprinklers ❑ Generator
S Ft. of First Floor: _
Utilities:- Sewer E Septic
OWNER/LESSEE: CONTRACTOR:
Lot No._
Block No.
❑ Windows/Doors
Roof
Building Height:
Name WILLIAM STAUB Name: CHRISTOPHER P LANGEL
Address: 10316 CROSBY PLACE Company: LANGEL AIR CONDITIONING
City: PORT ST LUCIE State: FL Address: 3108 INDUSTRIAL 31 ST STREET
Zip Code: 34986 Fax: i City: FORT PIERCE State: FL
Phone No. 772-466-4386 Zip Code: 34946 Fax: 772-466-3053
E-Mail: Phone No. 772-466-2400
Fill in fee simple Title Holder on next page ( if different E-Mail: DANISEACOASTAIR@AOL.COM
from the Owner listed above) State or County License: CMC035421
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
..............
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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 jobsite
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.
— 2Z_1011�! L A�
- u6i�l ' s
Signatur of Contractor/License Holder
Signature of/Owner/ Lessee/Agen
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFSTLUCIE
COUNTY OFSTLUCIE
The forgoing instr rnent was acknowledg before me
day
The forgoing instru ent was. acknowledged before me
AmIt
this of z0l�y
this day of 20 � by
CHRISTOPHER PLLANGEL
CHRISTOPHER P LANGEL
(Name of person acknowledging)
(Name of person acknowledging )
&Utu'J'Q'0QA-y
(Signature of Notary Public- State of Florida)
ignature of Notary Public- State of Florida )
Personally Known x OR Produced I r�
Personally Known x OR Produced Identification
Type of Identification Produce 9
Type of Identification Produced
Commission No. ,.gt�1S i6^2��
Commission N Vi` �jAik.E.E M�A�
xptFti �g
;•� my # FF 6145c' ,
ES-EebrUmy i6. 207`',
"5s
Revised 07/15,1 3 (4011y
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -
COMPLETE
INITIALS
I