HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0 o ?--7—J
Date: Permit Number:
Building Permit Application jUL 13 �01�
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,.Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED 1NPROVEMENT LOCATION:
Address: 11D 2 Op 15 C> ,-
Legal Description: CALX
Property Tax ID#: x4 5 t 1 - 5 c 5- n Of aLot No. C9`7
Site Plan Name: Block No.
Project Name: M 12+-t'et'"
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK:
Meal— c_-P 2 Iho i
CONSTRUCTION INFORMATION:
Itiona wo o e . orm under this perm -cnecK all appy:
HVAC Gas Tank as Piping _Shutters Windows/Doors
11 Electric Plumbing O Sprinklers Generator Roof
Total Sq.Ft of Construction: 1 S .Ft.of First Floor:
Cost of Construction:$ �9 fl DO Utilities: Sewer O Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name7kon aj&ct-t'aw-e.en YY?LlG 8e Name: PATRICK FLETCHALL
Address,1318 166Woad bri4r LACompany: COOL&RELIABLE AIR COND
F� Address. 1051 NE SANTA CRUZ DR
City��ek, 02J4 State:
Zip Code: '3444910J Fax: City: JENSEN BEACH State:
Phone No. (_n -v`i'i' 50 Zip Code: 34957 Fax:
E-Mail: ""`- Phone No. 772-692-5750
Fill in fee simple Tide Holder on next page(if different E-Mail:'rcool@bellsouth.net
from the Owner listed above) State or County License: CAC058567
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTALL CONSMUC' ON UEN:LAVA 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: Name'
Address' Address:
City: City:
Zip: Phone: Zip- Phone:
OWNER/CONTRACTOR AFFIOVIT:Application Is hereby made to obtain a permit to do the work and installation as Indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County make no representation that is granting a permitwill authorize the permit holder to build the subject structure
which is in conflict with az applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consultwyith yourHome 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 pians,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-resklenttal use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result M your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
.before the first inspef inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recordjnz your Notice of Commencement.
Sig re of Owner) int/Lessee fire of Cont o icense Holder
STATE OF FLORIDA STATE OF FL IDA
COUNTY OF 5-1—. 1 c_at,e, COUNTY OF 15±. Z 4.
The fofizoing instrument was acknowled d before me The forggo�ing instrument was acknowledged before me
this/ day of __,20�by this�'t''dayoi��[ 20Wby
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Pub
ic-State of Florida)
Personal) Known OR Produced identification Personally Known ✓ OR Produced Identification
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Type of Identlfica iota, d -: _ .. _ Type of Identification Produced
x. �
t ,,,..,...n _ DEBORAH FL'SSELL e� m D�p� e cr^
Commission No. •``t�"Y'�e' Commission No. .,,�„art RJs:lt
` _ A3otary PMI)State of Florida -oi c'- Public Slats of C' rid3 sz
•c my Comm.Expires idov 39 2913 .a �c Plolar
y Pu
' ,a In-ExpiresAiov 3� '3'�
&Tv Commss,on
Bonded through l i donil Nota,u Pi
Revised 0711 4 Boftdzd l!rnus h i�llt r i i vl'} .
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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