HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/09/2016 Permit NumberLoo
:
. = R E C E I V�D
Building Permit Application
AUG 10 2016
Planning and Development Services
Building and Code Regulation Division PERMITTING
ITTiNG
St
2300 Virginia Avenue, Fort Pierce FL 34982 . Luucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION':
Address: 9811 PERFECT DR 183
Legal Description: GOLF VILLAS II UNIT 183 (OR 2128-728)
Property Tax ID#:
3327-703-0135-000-6 Lot No.
Block No.
Site Plan Name:
Project Name: Thomas Williams
Setbacks Front Back: Right Side: Left Side:
FDETAILED DESCRIPTIONOf WORK:
A/C CHANGE-OUT OF 2 TON RUUD UNIT 16 See"
r/L
CONSTRUCTION INFORMATION:
Additional wor to e e or me un er t is permit—c ec a appy:
❑✓ HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
❑_Electric Plumbing Sprinklers a Generator L3 Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ 3100 Utilities:Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name
Thomas Williams Name: GRETA B.SMITH
Address:
511 E San Ysidro Blvd Unit C-363 Company: ALL YEAR COOLING &HEATING
Linee
San Ysidro State:CA Address: 1345 NE 4TH
173 Fax: City: FORT LAUDERDALE State:FL
33304 Fax: 954-617-3798
Zip Code:
Phone No. 954-566-4644
ple Title Holder on next page (if different E-Mail: DDANIELS@AYCAIR.COM
ner listed above)
State or County License. CAC058160
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 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
commencin work or recording our Notice of Commencement.
e�_
nats
_Signature of Owner/Lessee/Agent Sigure of ContraCtorAicense Ho der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIF COUNTY COUNTY OF BROWARD
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 9 day of AUGUST 20 16by this s day of AUGUST 20 16 by
Thomas Williamsl _ GRETA B.SMITH
(Nam (Naotp7,4�n aCKnowleagling
;�.s+` 4% DIMITRIUS A DANIELS
��; •= 1A � ��� / /� _ •= MY COMMISSION#FF173126
f ;SCK M1 EXPIRES October 30.2018' —
(Signa / Irl a (Sig romtAlaAtar Pbblililil Jerrrda )
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF173126 (Seal) Commission No. FF173126 (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS