HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 619/2016 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 143 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0329-000-3
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
I DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
Right Side: Left Side:
Change out 3 ton 15 seer Rheem heat pump split system 5 kw heater like for like
9
witional worKto oe errormea
E] Gas Tank
unaertnis permit—cnecKau
E]Gas Piping
Name Judith Hays
apply:
Shutters
❑. Windows/Doors
HVAC
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No. 772-249-5182
_
City: Port St Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
11 Electric ❑ Plumbing
Sprinklers
1:1
Generator
1:1 Roof
Total Sq. Ft of Construction: _
Cost of Construction: $ 4500.00
SFt- of First Floor: _
Utilities: Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Judith Hays
Name: Vance R Corbin
Address: 143 Nettles Blvd
Company: Dodd Enterprises Inc
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No. 772-249-5182
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 Holder 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 $2500 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:
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 Horne 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; your Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA �--,i
COUNTY OF 3j,
r
The fX
going instrum nt was acknowledged before me
this day of � L 20 Wby
1 -
(Name of person acknowledging)
C
(Signature of Not P}ablic- State of Florida )
Personally Known O
Type of Identifi at— '�,�vduc
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Revised 07/15/2,-014
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Signature of Contractor/License Holder
STATE OF FLORIDA � j ��i
COUNTY OF + tel.
The forgoing instrum nt was acknowledged before me
this day of " 20 ( ' by
(Name of person acknowledging)
(Signature of Not Public- State of Florida )
Personally Known OR Produced Identification -
Type of Identification Produced
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