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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 p 2 Date: 06-01-2016 Permit Number: • Building Permit Application ,uN 201 Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 6013 CASSIA DRIVE Legal Description: Property Tax ID#: 3402-610-0453-000-6 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front .Back: Right Side: Left Side: DETAILED.DESCRIPTION OIF;WOR:K: ,a AIR CONDITIONING EXACT CHANGE OUT a -ron 1q, 000 8T01H fy Seer— 5_X W PeaTey CONSTRUCTION INFORMATION: Additional work to be nertormed under t ispermit—check all appy: HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors 11 Electric ❑ Plumbing Sprinklers I Generator 11 Roof Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$ 2000 Utilities:n Sewer[]Septic Building Height: OWNER/LESSEE.: _ CQ.NTRACTOR:. . Name Name: GUSTAVO VELEZ Address: company: REGOSA ENGINEERING SERVICES City: .�'2���, State:;jE�/ Address: 15700 NE 2 AVE Zip Code: 3 3/0�, gFax: City: MIAMI State:FL Phone No. 1�- (Q10 Zip Code: 33162 Fax: 305-945-4367_ E-Mail: . Phone No. 786-262-2964 Fill in fee simple Title Holder.on next page(if different E-Mail: CONTRACTORWORK@GMAIL.COM from the Owner listed above) State or County License- CMC-1427292 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 1J SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Roca Housing Solutions LLC Name: Address: 419 WEST 49 STREET,SUITE 217 Address: City: HIALEAH,FLORIDA City: Zip: 33012 Phone: 305-338-1669 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 buil a subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may res ict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions ich ay apply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,per orm t e 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:roo additio s, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to anothe non-resi ential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in y ur payi g twice for improvements to your property. A Notice of Commencement must be recorded and osted n the jobsite before the first inspection. If you intend to obtain financing, consult with lender or a atto ey before commeuing work or recording our Notice of Commencement. s _Siviture of Owner/Lessee/Agent Signature of Contrac n e HLldSTArr//TE OF FLORIDA ;� STATE OF FLORID COUNTY OF M/A14 I- ✓fi�E COUNTY OF MIAMI-DADS The forgoing instru ent was acknowledged before me The forgoing instrument was acknged before me this qday of UIJC— 20 /�by this 1 day of DUNE 20 by Am 1©. 6lv?Z-L07- (Name of person acknowledging) (Nam of per on acknow edgin �;; Y LUZ EDITH GIRALO '. '4:? MY COMMISSION#FF203 EXPIRES MarCh 22.2019 0 , 3{i?-p'53 FbndaNW.a•yService.coa (Signature of Notary Public-State of Florida) (Signature of Notary 70R -State of Florida) Personally Known /--.,--OR Produc Personally Known Produced Identification Type of Identification P 1 Type of Identification Produced MAIUA A.IV, MY COMM SSIONJI F 1140Sit Commission No. EYPII s��t2 22ots Commission No 0 (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS