HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/10/2016 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 xx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
PROPOSED IMPROVEMENT LOCATION:
Address: 5404 SHANNON DR
Legal Description: LAKEWOOD PARK -UNIT 12- BLK 158 LOT 5 (MAP 13/12S) (OR 3705-72
Property Tax ID #: 1301-614-0033-000-2
Site Plan Name:
Project Name: NEW AIR CONDITIONING
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
REPLACE AIR CONDITIONING EQUIPMENT. LIKE FOR LIKE
CARRIER 14 SEER 2.5 TON 8 KW HEAT
✓❑_HVAC UGasTank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
r tnls permit —
Piping LJ Shutters
nklers ❑ Generator
SFt. of First Floor:
Utilities: Sewer Septic
Lot No.
Block No.
❑ Windows/Doors
11 Roof
Building Height:
OW N'ERAESSEE:
CONTRACTOR:
Name Elba Torres
Name: AJC DOCTORS INC
Address: 824 SW Java AVE
Company:
City: PORT SAINT LUCIE State: FL
Zip Code: 34953 Fax:
Phone No. 7726269718
Address: 850 NE FEDERAL HWY
City: STUART State. FL
Zip Code: 34957 Fax: 7726075700
Phone No. 7723443944
E -Mail: torresl23192@gmail.com <torresl23192@gmail.com>;
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: ACDOCTORSINC@GMAIL.COM
State or County License: CAC058461
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
x Not Applicable
Address:
Address:
REVIEW
City:
Zip: Phone:
State: _
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
x Not Applicable
Address:
Address:
COMPLETE
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,insqtion."ou intend to obtain financing, consult with lender gjra attorney before
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STATE OF FLORIDA
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The forgoing instr ent was acknowledge before me The forgoing in Iment was acknowledg�d` LIP
me
this day of 20by thi4S- day o SZ� S'
20 by
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((NNaam�ee of person acknowledging )
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Personally Known OR Produced Identification
Type of Identification Produced
Commission No.b�
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Revised 07/15/2014
(Name of person acknowledging )
(Signature o otary Public- State of Florida )
Personally Known OR Pro�ceedd Identification
Type of Identification Produced
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
DATE
COMPLETE
INITIALS