HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
LS
•
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
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Legal Description: r /,UV'LA _!*
Property Tax ID M. i ' Lot No.—Ln_
Site Plan Name
Project Name:
Setbacks
Front Back: Right Side: Lek Side:
Replacing A/C, exact change out, no duct work with a . 6 -'t-on CcL-r r',--e-C
AIC
JUILIUIIdl WUIK W U 11VllCU UIIUCI
HVAC Gas nTank
11 Electric El Plumbing
LIIIS
❑Gas
lJCrlilli—LnCLK au apply:
Piping_ Shutters Q
Sprinklers E Generator
Windows/Doors
Roof
Address: bx_25L-i�Pt"fY1lV i�,y)z _
Total Sq. Ft of Construction: S Ft. of First Floor: _
Cost of Construction: $� � Utilities,
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Zacek, Dennis
Address: bx_25L-i�Pt"fY1lV i�,y)z _
Company: American Residential Services
City: _Vk- P ► �rr� State:
Address: 2800 US Hwy 1
Zip Code: Fax:
City: Vero Beach State: FL
Phone No. ��J " [��� �' �(��
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 LAIN 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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize thepermitholder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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 mayresult 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.
T_ Signature of Ow r/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF st.Lude
The forgoing instrument was acknowledged before me
this 2 day ot�� b -e -- _ _ 20 QDby
Dennis Zacek
(Name of person acknowledging }
(Sign ure of Notary Public- State QFrida }
e I� ,- s
Signature of Cont or/License Holder
STATE OF FLORIDA
COUNTY OF smucie
The forgoing instrument was acknowledged before me
this _J_ day of t. t )f'1 -Q- , 20 _I LQby
Dennis Limit
(Name of person
of Notary Public-SUtAof Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF220930
A DERBY
No.
BETH A DERBY
EXPIRES April 15, 2019 14!PP' —� •• , F ""u930
EXPIRES AAri! 15. 2018
Revised 07/15/2014 #lket__i �n5 a sa F+or+aeMararyse�.ke.mrr '+a', a'a 0's3 F+oraekae g
Y e'+nce torr
REVIEWS FRONTZI ONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
COMPLETE
INITIALS
Property Identification
Site Address:
Parcel ID:
Account #:
Map ID:
Use Type:
Zoning:
City/County:
Ownership
James M Reed
Carne D Reed
10615 US 50
Hillsboro, OH 45133
Legal Description
GREEN ACRES UNIT TWO S, D BLK 4 LOT 6 (OR 3861-1399)
Current Values
Just/Market Value:
513,000
Assessed Value:
513,000
Exemptions:
s0
Taxable Value:
513,000
Taxes for this parcel- SLC Tax Collector's Office 0
5234 AMY LN
1430-701-0030-000-5
10273
14-30S
0200
RMH-5
Hint Lucic Cour
Total Areas
Finishcd/Under Air (SF): 794
Gross Area (SF); 996
Land Size (acres): 0.17
Land Size (SF): 7,500
This information is believed to be correct at this time but it is subject to change and is not warranted.
0 Copyright 2016 Saint Lucie County Property Appraiser. All rights reserved.