HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/09/2016 Permit Number:
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Building Permit Application AUG 2 4 2016
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
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PRQPOSED If11�PRQ1/EMENT LOCATION ` 2
Address: 392 HOLLY AVE
Legal Description: RIVER PARK-UNIT 2-BLK 20 LOT 15(MAP 34/22N)(OR 720
Property Tax ID#. 3419-510-0296-000-2 Lot No.
Site Plan Name: Block No.
Project Name: KENNETH HAYDEN
Setbacks Front Back: Right Side: Left Side:
k a y a to 3 ka ,
DETAlLE® DESCRIPTION OF WORK 3'
A/C CHANGE-OUT OF 3.5 TON YORK UNIT Se 0- KVJ
CCINSTRUCTION�lNFOR1VIATION
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Additional work toe e orme under this permit—c ec a appy:
OHVAC E]Gas Tank E]Gas Piping In Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers ElGenerator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 3600 Utilities:n Sewer OSeptic Building Height:
C►WNERJLES5EEa CONTRACTOR
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Name KENNETH HAYDEN Name: GRETA B.SMITH
Address:329 HOLLY AVE Company: ALL YEAR COOLING &HEATING
City: PORT ST LUCIE State:FL Address: 1345 NE 4TH
Zip Code: 34952 Fax: City: FORT LAUDERDALE State:FL
Phone No. Zip Code: 33304 Fax: 954-617-3798
E-Mail: Phone No. 954-566-4644
Fill in fee simple Title Holder on next page(if different E-Mail: DDANIELS@AYCAIR.COM
from the Owner listed above) State or County License: CAC058160
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUtPPLEMENTA'L 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 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 yo aying twice for
improvements to your property. A Notice of Commencement must be recorded a posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender r an att., rney before
commencingwork or recordingour Notice of Commencem nt.
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_Signature of wner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY CO U NTY OF BROWARD
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 23_day of AUGUST 20 16by this 23 day of AUGUST 20 16 by
KENNETH HAYID�N GRETA B.SMITH
(Na ackn <--Mame of nowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced -Q Type of Identification Produced G•q
Commission No. FF173126 a Commission No. FF173126 a
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DATE
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INITIALS