HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED "
Date O '�� 1 �, Permit Number: J � 0�, V 0q l
Building Permit Application
Planning and Development Services AU6 m 4 2016
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
RROPO3.Eb IM'.PR( V MENT
Address: 2511 s jenkins road
Legal Description:
Property Tax ID#• 2324-144-0001000-1 Lot No. ^
Site Plan Name: Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side: ,-
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like for like change out (1) 3 ton carrier ac system 16 seer 10 kw
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Additional work to ff
orme un ert ispermit—c eG a appy:
ZHVAC Gas Tank E]Gas Piping _Shutters Windows/Doors
11 Electric El Plumbing Sprinklers 13 Generator Roof
Total Sq.Ft of Construction: S . Ft-of First Floor: .-
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Cost of Construction:$ 5463.00 Utilities: Sewer Septic Building Height:
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OV AWNER ,.y
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Name Opal p Norvell _ Name: Christopher Lange!
Address.2511 s jenkins road Company: Soa Coast AIC _
City: ft pierce State:fl Address: 3108 Industrial 31st St
Zip Code: 34947 Fax: City: Ft Pierce state:fl
Phone No.772-464-2860 Zip Code: 34843 Fax: 466-3053
E-Mail: Phone No. 466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: tlseacoastair@aol.com
from the Owner listed above) State or County License: cmco35421
If valueof construction is$2500 or'more,a RECORDED Notice of Commencement is required.
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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.,
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 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
commencing work or recording our Notice of Commencement. y�
_Signatur of Owner Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5tluG1e COUNTY OF=Ciel=
The f oing instru ent was acknowledg d efore me The forgoing instrument was acknowledged before me
this day of 20�by this a day of 81�_.. 20 _by
Chr]sfopher Lari94 Christopher Lange]
(Name of person acknowledging) (Name of person acknowledging)
ignature of Notary Public-State of Florida) -gnat of N6't@N Publl -State of Florida)
Personally Known x OR Produced Identification._ Personally Known x OR Produced identification
Type of Identification Produced LT pe of identification Produ
°, ,IUS1�l1 i;,H010111S�ONNf�lY 11 ,Al81iNA FIOMECQNMLY
Commission No. ( 1i11F0KWWION#FF941411 Immission No- TT ._, Mt�Q WON 0FF941411
- EXPIRES,December 0,2019 ' WIRES:voumber6,2o19
ti 9dldedTllN Pu08aUn00 .$;,,,• 8A1KiO UWN*rPYLBCUedQ1YRihiB
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS