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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 6/16/2016 Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division y 2300 Virginia Avenue, Port Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 2102 Nettles Blvd Legal Description: Parcel 1D # 4502-501-0105-000-7 Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Lot No. Block No. DETAILED DESCRIPTION OF WORK: I Change out 2 ton 16 seer Rheem st cool split system 7 kw heater like for like 0 Additionalworkto be erformed under this permit —check all Mat apply: HVAC Gas Tank Gas Piping _ Shutters ❑ Windows/Doors ❑ Electric ❑ Plumbing Sprinklers Generator L1 Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 4500.00 Utilities: Sewer 0 Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Andrew Perhach Name: Vance R Corbin Address: 2102 Nettles Blvd Company: Dodd Enterprises Inc City: Jensen Beach State: A Zip Code: 34957 Fax: Phone No. 772-229-3022 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: y 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 the permit holder to build the subject strugture 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 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 G 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 COUNTY OF r The fo ping instrumvt was acknowledged efore me this day of 20 iQby � r (Name of person acknowledging) _2R 1 (Signature of Notarv—Khlic- State of Florida ) Personally Known OR Produced Identification Type of Identification. Produced CommissiQn-No.S — t 1 gUZETTE R3 fE �y �U 1ON #F:FOa"1868 _x 4= EXPIRES December 12. 2017 f-,ediSed 77.�3 FlaridaNataryService.com 3saa45� - Signature of Contra for/License Holder STATE OF FLORIDA & (UC, COUNTY OF The forgoing instr ent was acknowledged before me this -�--`- day of l" 20 by ry A f (Name of person acknowledging) [Signature of Ndti6y Public- State of Florida ) Personally Known V OR Produced ldentifcztion- Type of Identification Produced Commis i5(T(o:.-. � el}�.- RITCI ! • - = - y My COMMISSION #FF06i M-nr imtb uecember 1 P. r ; 10tiddNciary5ervlre cOr . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE - - CO`bNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE M -— COMPLETE INITIALS