HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: {l Permit Number:
e
a
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
I PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION: I
Address: 12, LA Z0rZ0_k 'Avg
Legal Description: �SyAntsVi L-dICGS 7Qu rl� gsj S
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replacing A/C, exact change out, no duct work with LA tA G-1 r r % ejr 1 LA
5 r v� pa le a n 14--.
CONSTRUCTION INFORMATION:
Aaamonal work to flasTank
orme un er t is permit— c ec a appy:HVAC E]Gas Piping _ Shutters Q Windows/Doors
11 Electric 11 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ r S � Utilities: Sewer El Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name. zacek, Dennis
Address
Company: American Residential Services
City: q State:Mf�
Address: 2800 US Hwy 1
Zip Code: Fax:
City: Vero Beach State: FL.
Phone No 2T-P),Zip
Code: 32960 Fax: 772 794-9783
E -Mail:
Phone No. 772 794-7221
Fill in fee simple Title Holder on next page ( if different
E -Mail: bderby@ars.com
from the Owner listed above)
State or County License: CMC1249753
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 thepermit 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
commencine work or recordine vour Notice of Commencement.
r I r S
_ Signature of Ow er/ Lessee/Agent Signature of Contor/License Holder
STATE OF FLORIDA
COUNTY OF St. Lucia
The forgoing instrum t was acknowledg before me
this _q day ofA 20 y
Dennis Zacek
(NaMe of person acknowledging) �1
(Signature of Notary Public- State of I rids )
STATE OF FLORIDA
COUNTY OF St Luce
The f Ting instrum nt was ack wledged before me
this day o 20 �y
0
Tennis Zack 10 --
(Name of person acknowledging )
of Notary Pum- tate of
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Prod u ed
Commission NO. FF220430 NOFF220430;�H A pSR�Y£
MY COMMISSION # FF22093D
SFD.z: MY COAAMfSSION # FF7�,
Revised 07/15/2014
ccn•
53 - •�� npril 15. 20i9
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
Property Identification
Account #: 011053 Identification #:
719520188169
Account Status: Open Location: 13974 Zorzal AVE
C' rit Lucie County ) Business Name: Doherty,
Joseph
Business Type: 7195 - Sp DBA: Doherty, Diana
Lks Fairways Contact: Joseph Doherty
State Code: 814110 - Private Year Added:
Households
Ownership Current Values
Doherty, Joseph
Market Value:
32 Dudley ST
$0.00
Reading, MA
01867
Return
MH Util Rm
Received:
Asset
Not Yet
MH Screen
Received
Room
Penalty: None
Exemptions
Grant Exemption Exemption Exemption
Year Code Description Value
2008 TPPX Tangible Personal
Property Exemption
Asset Group and Value
Asset
Value
MH CentralAC
$320.00
4.OT
Asset
Value
MH Util Rm
$82.00
Asset
Value
MH Screen
$56.00
Room