HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9 Aug 2016 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 XXX
PERMIT APPLICATION FOR: Mechanical
Address: 5603 PLACE LAKE DRIVE, FORT PIERCE, FL, 34951
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Fr
Back: Right Side: Left Side:
Lot No.
Block No.
A/C change, like for like with a 5 ton 14 Seer heat pump with 10kW backup electric heater.
HVAC
u
Gas Tank
11 Electric
1:1 Plumbing
Total Sq. Ft of Construction:
Cost of Construction:
$ 5125.00
City: Vero Beach State. FL
Zip Code: 32960 Fax: 772-770-0507
Phone No. 772-770-0507
unaerthispermit— cnecKau appry:
❑Gas Piping _ Shutters ❑ Windows/Doors
Sprinklers Generator Roof
Sq. I �Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jack Barqui
Name: James T. Smith
Address: 5810 Santa Maria Ave #205 Ste 8-185
Company: Comfort Zone A/C and Heating of Florida
City: Laredo State: TX
Zip Code: 78041 Fax:
Phone No, 772-538-8882
Address: 3200 43rd Ave Suite 6
City: Vero Beach State. FL
Zip Code: 32960 Fax: 772-770-0507
Phone No. 772-770-0507
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: Jim.Smith@TheComfortZoneFL.com
State or County License: CAC057477
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER- Not Applicable
Name: _ _
Address:
BONDING COMPANY: _Not Applicable
Name:
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
commencint; work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF ._ s �--c I a„--- � V2
The forgoing instrument was acknowledged before me
this` i 1-' day of V�- c I , 20 <-a by
Signature of Contractor/License Ho
STATE OF FLORIDA
COUNTY OF - y
The forgoing instrument was acknowledged before me
this, day of vVL =:�� 20 1 �-- by
(Name of person acknowledging) (Name of person acknowledging J
(Signature of Nota Public- State of Florida) (Signature of Nota_ ry)Public7State of Florida )
Personally Known :--� OR Produced Identification Personally Known L.�OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Seal Commission No. EYP° IflCKYCODO
(Sea]) \ACKY CODD j&ISSION #FF989887
MY COMMISSION #FF989887 }rx � p(PlF ES; MAY 08, 2020
PIRES; MAY 09, 2929 34 LW-wv
Fm
Revised 0'711512014 Bonded through 1 st State Insurance
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS