HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 _
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 748 Altura Street Port St Lucie FI 34952
Legal Description: RIVER PARK-UNIT 3- BILK 24 LOT 11(MAP 34/22S) (OR 3795-861)
Property Tax ID#: 3419-515-0117-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install New Goodman 2 Ton 16.00 SEER air handler and condensing unit with 05 KW heat like for
like
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit—check a that appy:
HVAC 11 Gas Tank F]Gas Piping ❑_Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 2,575 UtilitiestSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Lina Uriol Name: David Poling
Address: 607 SE Faith Ter Company: All Star Air Inc
City: Port St Lucie State:FL Address: PO Box 881634
Zip Code: 34983 Fax: City: Port St Lucie State: FL
Phone No. (312) 612-0453 Zip Code: 34988 Fax: 772-878-0325
E-Mail: Phone No. 772-878-0425
Fill in fee simple Title Holder on next page ( if different E-Mail: Allstarair@yahoo.com —
from the Owner listed above) State or County License: State CAC1816883 County(26958)
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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: 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 Counter 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
commencing work or recording our Notice of Commencement.
s
_Signature o Owne Agent Signature of Contractor/L nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Saint Lucie COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 7th day of August 20 1113 this 7th day of August 20 16 by
A� David Poling David Poling
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known n OR Produced Identification
Type of Identificalrin Produced Type of Identification Produced
NICHOLAS ALBERSNICH
OLAS(4^BERS
Commission No. :fCommission No.
. M COMM15 #FF916245 COMMISSION 0 FF916245
a,rr EXPIRES September 29,2019 EXPIRES Se tem
14 1139+-0�63 %rktallote,yServ�ce.corr M.ery3 FbrkteNoe� Sarwoe,corr
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
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