HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I.1.(9. Permit Number:..`(0, (31' 1 oG
RECEIVED SES' 0 S 2016
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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 a
PERMIT APPLICATION FOR:; Mechanical
PROPOSED IM°PRQVEMENT LOCATION {z
Address:
Legal-Description: 14armC�
Property Tax I D ®Q0 7 Lot No,23'r'P
.Site Plan Name: Block No.
Project Name: ; 04<5i o 1')
Setbacks Front Back: . Right Side:: Left.side:
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DETAILED DE�CR(PTION 0'F WORK 0
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t
Po r n rk- Lo Ir �(.� bea 4qo r-
CONSTRUCTION INFOIiM� TION' k
Additional work to.be e orme . uncler this permit-check a appy:
VAC H Gas Tank as Piping _Shutters Windows Doors.
� a ,
tElectric 0 PlumbingSprinklers Generator Roof
Total Sq. Ft of Construction: L SFt.of First F(oor..
Cost of Construction:$ ��•�i� Utilities:ESewer USeptic Building Height:
OWNERjLESSEE*f 5 x CONTRACTQR
Name. nrvaJ Name: TODD oEJARNETiE
Address: r company: GXAIR CONDITIONING
City: I WC4 State:FL Address: 1401-SW MEDINA AVE
Zip Code: ';,�4 44L2 Fax: �- Clty; PORT ST..L.UCIE State:FL
Rhone No. /a S—. (o . Zip Code 34953 Fax:
E-Mail: Phone No 7:72-344-5520
Fill ln. :fee simple Title Holder on.next page(if different E-Mail: 9xairheat@yahoo com
from the Owner listed above) State or County License: CAC1814487.
tfwaiue of construction is$2soo.or more,a RECORDED Notice of Commencement is required:
xSUFFLEMENTAC CONSTRUCTION LIEi LAVU INFt}'RMATION
.. .'r
DESIGNER/ENGINEERc _Not App{icable 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:
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 oranscovenants that may restrict or prohibit such
structure.Please consult with your Home Owner's.Association and review your deed for any restrictions.which may apply.
In consideration of the granting of this requestedpermit;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.exemptfrom 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 mayresult: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 recordinAyour Notice of Commencement.
ignature ofownerf Age /Lessee Signature of Contractor/ icense Holder
STATE.OF FLORIDA STATE OF FLORIDA
COUNTY OF A '� COUNTY OF -i- L-ULGi b
The forg ing instrument was acknowledged before me The forgoing instrument.was acknowledged before me
this_R2y of .mI S 20' l&Oby this�'�Ot'day of 20_pby
(Name of person acknowledgin (Name of person ackno dging)
(Signature of Notary Public-State of Florida} (Signature of Notary.Public-State of Florida)
Personally Known OR,Produced Identifi io Personally Known. -O
' R Produced Identification
Type of Id, Type of Identification Produced
.`'AvP, � DEBORAH RUSSELL
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Commissi - N tar Public-St4g�@}I f lorida Commissio
ago
Commission N FF 179630 wh
ORAH RUSS�1.�3y s' x ins Nov 30.20.18 Notary Publlc-Stata of Florid,
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Commis
Revised 2 ,,,�,f��,,.,'� my Comm.Expires Nov 30.2015
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