HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6110/2016 Permit Number:
s
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 4621553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 5949 Alexandria Circle, Fort Pierce, FL 34982
Legal Description: PALM GROVE SID BLK F LOT 12 (0.12 AC) (OR 1497-449)
Property Tax ID #: 3410-503-0181-004-4 Lot
No.
Site Plan Name: Block
No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE LIKE FOR LIKE 3.5 TON HEAT PUMP WITH 5KW HEAT SPLIT SYSTEM WITH
BRAND NEW 14 SEER GOODMAN 3.5 TON HEAT PUMP WITH 5KW HEAT
CONSTRUCTION INFORMATION:
Additional work to jeer orme under this permit — Check a apply:
HVAC I_J Gas Tank Gas Piping _ Shutters Winclows/C
11 Electric 0 PlumbingSprinklers Generator Roof
ours
Total Sq. Ft of Construction: SFt. of First Floor: 1$12
Cost of Construction: $ 2299.00 Utilities: Sewer E Septic Building Heig
t:
OWNER/LESSEE:
CONTRACTOR:
Name Helen Lein
Name: Robert Hennis
Address: 5949 Alexandria Circle
Company: Air Control AC and Refrigeration, LLC
City: Fort Pierce State:FL
Address: 5415 Silver Oak Drive
Zip Code: 34982 Fax:
City: Fort Pierce State: FL
Phone No. 772-460-7948
Zip Code: 34982 Fax: 7724 46613
E-Mail:
Phone No. 772-460-2665
Fill in fee simple Title Holder on next page S if different
E-Mail: AIRCONTROLAC@YAHOO.COIV
State or County License: CAC1815015
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
DESIGNER/ENGINEER: x Not Applicable
Name:
Address:
MORTGAGE COMPANY: X No
Name:
Address:
City:
Zip: Phone:
Applicable
State:
City: State:
Zip: Phone:
MANGROVE
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: x Not
Name:
Applicable
Address:
City:
REVIEW
City:
Zip: Phone:
REVIEW
Zip: Phone:.
DATE
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 the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrictl 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 0 r
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-resid ntial use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your payin 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 recording vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me
this day of 1 20 _by
WILLIAM PALLAD140
(Name of person acknowledging )
Signature of Contractor/License H
STATE OF FLORIDA
COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me
this day of 20 _by
WILLIAM PALLADINO
(Name of person acknowledging )
I.�� � ./�Li�etil? ! �ZCxK—� �� ll.+./ �-CEJ-L.Y! �-T �/ •L�d: ^----""
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced [dent`fication
Type of Identification Produced Type of Identification Produced
Commission No.( -.E x C%!r i *"" °�'er,� WWW PALLMNO Commission No. EC ;tvF,5 It, (Se
* MY COMMISSION # EE 208518 '0 I.T.. °k4 WILLIAM PALM
" xPIRES: June 14, 2016 MY COMMISSION 1I EE
9ardeanrueudgesNonlrx EXPIRES: June 14,,'
Revised 07/15/2014 ''/�'a�4� Itoarrwauo�nr�arl
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS