HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
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
I PERMIT APPLICATION FOR: Mechanical I
PROPOSED IMPROVEMENT LOCATION:
Address: `1805 ffik mgr IsV J�7-�- PesCCae � L 3 4 R'51
Legal Description: lr.GAk-r i,�� 1L On i4- 3 Y,'_0 L.a� ZLp
Property Tax ID #: 1301 • Loo -6 - 01 L15 - OM • 3 Lot No. Q
Site Plan Name: 'Avrra�-Ip Block No. a0
Project Name: 1AY-C"
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replacing A/C, exact change out, no duct work with 3 -1-a � FZ.h-ce.rn Iia Sc"C ,
10 k.,J SQI,t 'Ac�C
CONSTRU137ION INFORMATION:
ltiona wor to e e orme under tispermit-c ec a appy:
HVAC E] Gas Tank E:] Gas Piping _ Shutters Q Windows/Doors
Electric 0 Plumbing ❑Sprinklers Generator 11 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ C L?LA, % �
S Ft. of First Floor: _
Utilities* ElSeptic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name 1A rr0 O kart CA,
Name: Zack, Dennis
Address: '1'9 o't P00ma r St _ _
Company: American Residential Services
City: PIr O rte_State: L
Address: 2800 US Hwy 1
Zip Code: 3 c1 l Fax:
City: Vero Beach State: FL
Phone No.� �a20
Zip Code: 32960 Fax. 772 794-9783
E -Mail:
Phone No. 772 794-7221
Fill in fee simple Title Holder on next page I if different
E -Mail: bderby@ars.com
from the Owner listed above)
State or County License: CMC1249753
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
MORTGAGE COMPANY., x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: x Not Applicable
Name:
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 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 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
commencine work or recordine your Notice of Commencement.
3=L I 5r�:� 5
_ Signature of Owr r/ Lessee/Arent Signature of Cant or/License Holder
STATE OF FLORIDA
COUNTY OF St.Lede
The f r oing instr m nt was acknowledged before me
this day of 20 4by
Dennis Zack
(Name of person acknowleflgiig )
of Notary
Personally Known x
Type of Identification
Commission No.
Revised 07/15/20
of Florida )
Identification
STATE OF FLORIDA
COUNTY OF sit-,-
Thefor oing instrument was acknowledged before me
this day of 20 _L.LQ by
Dennis Zack
(Name of person acknowledgin�j
(?,",
(Signa ure of Nota ublic- Stat Florida )
Personally Know x OR Produced Identification
Type of Identific t(gp.P.Cq
DERBY Commission
'e—MY COMMISSION N FF220930
EXPIRES April 15 2019
53 NrvdeNc:*-ySe ,re
MY Cn .,„ A � I PY
EXPIRES April15. 2019
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