HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone- Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: 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, wails, 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.
_ 5ignature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF
The forgoing instruent was acknowledged before me
this'd day of c U'L'p , 20 acknowledged
(Name of person acknowledging)
(Signature of NotaryL,5ublic- State of Florida ]
Personally Known - OR Produced Identification
Type of Identification Produced
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Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The for oing instru nt was acknowledg d before me
this day of � 20 y by
(Name of person acknowledging)
(Signature of No Public- State of Florida 7
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Personally Known tl� OR Produced Idedificatiain
Type of Identification Produced
Commission No.
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MY COMMISSION #FF061868
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SUPERVISOR PLANS VEGETATION SEA TUK I Lt MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
ALL 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, Fart 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 #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out 3 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
9
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all apply:
HVAC Gas Tank OGas Piping Shutters [ Windows/Doors
L�IElectric Plumbing 1:1Sprinklers LJ Generator 1:1 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 3500.00
OWNERAESSEE:
Name John Stevens
Address: 781 Nettles Blvd
SFt. of First Floor:
Utilities:Sewer E]Septic
City: Jensen. Beach State: FI
Zip Code: 34957 Fax:
Phone No. 267-483-8221
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: Vance R Corbin
Company: Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail: doddenterprisesgdodd.com
State or County License: CMC1249958
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.