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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 61212016 Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 781 Nettles Blvd Legal Description: Parcel ID # 4502-501-0967-000-7 Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: DETAILED DESCRIPTION OF WORK: Lot No. Block No. Right Side: Left Side: Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like 9 Additional work to be pertormed under this permit—check all apply: HVAC Gas Tank OGas Piping Shutters [ Windows/Doors L�IElectric Plumbing Sprinklers L_I Generator Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 3500.00 Utilities:Cn Sewer E]Septic Building Height: OWNERAESSEE: CONTRACTOR: Name John Stevens Name: Vance R Corbin Address: 781 Nettles Blvd Company: Dodd Enterprises Inc City: Jensen Beach State: FI Zip Code: 34957 Fax: Phone No. 267-483-8221 Address: 1296 SE Industrial Blvd City: Port St Lucie State: FI Zip Code: 34952 Fax: 335-3310 Phone No. 398-2344 E -Mail: Fill in fee simple Title Halder on next page ( if different from the Owner listed above) E -Mail: doddenterprises@dodd.com State or County License: CMC1249958 If value of construction is 52500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: x Not Applicable Name: MORTGAGE COMPANY: x Not Applicable Name: Address: Address: City: State: Zip: Phone- City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable Name: BONDING COMPANY: x Not Applicable Name: Address: Address: City: City: Zip. Phone: Zip: Phone: 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 Dome 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 l 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 fall 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 commencina work or recording our Notice of Commencement. n ,R _ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA r j n, STATE OF FLORIDA Uo COUNTY OF COUNTY OF r The forgoing instrurykent was acknowledged before me ` The for oing instru nt was acknowledg d before me 2 � this day of L 20 y this day of 20 by (Name of person acknowledging) (Name of person acknowledging) n { -cut (Signature of No Public—State of Florida (Signature of Notary ublic- State of Florida ] Personally Known OR Produced Identification Personally Known tl� OR Produced Identification Type of Identification Produced Type of Identification Produced _. Co �, o. _....r,-rG sa�-FCHIE(S I) .i Commission No. (S a�j - .' #FFQ18fi COiAtAiSSION�R'ra� ., x MY HIE ar��' eC8 5etv;ce.c " MYCQMiV11SSigN#FFOB1868 a EXPIRES December 12, 2017 FbridaN daryServlce.com REVI-EWS -FRONT ZONING SUPERVISOR PLANS VEGETATION SEA MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE - . COMPLETE INITIALS