HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED.FOR APPLICATION TO BE-ACCEPTED ,
Date: 1 Permit Number.. ILD
- Building Permit Application. .
SEP 14 2016 ..
Planning and Development Services ✓I I I`l i ISG .
Building and Code Regulation Division `' " LUC1e'County, FL'
2300 Virginia Avenue,Fort Pierce FL 34982 -
Phone: (772)462-1553 Fax: (772)462-1578 Corhmercial Residential X
PERMIT APPLICATION FOR: Mechanical
P:ROPOSED"fMPROVE 'ENT LOCATION,
Address: �, - �
Legal Description:
Property TaxID#:- 0122 -00 Lot No.
Site Plan Name': Block No:
Project Name:
Setbacks Front Back:' Right Side: Left Side:
DETAILEDDESCRIPTION'OF WORK
head 15 5L0? . );ke. ter- I 'Lf,
y y r s
CONSTRUCTION IN'FORMATI,N r -
Additional work to be nertormed under this permit-check all appy:
Z✓ HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof .
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$. . Z Utilities: Sewer'�Septic Building Height:
OWNER/LESSEE. ' - r CONTRACTOR' ,::
Name Di 6r_ �arr1 Lc;nYl Name James J Wauters
Address: 556 3 kA61_1 n.rr1' Pd Company: Just Chillin'HVAC°LLC
City: . Pi 2� State:FL Address::$422 NW Cromey St
Zip Code: 3uq�i. Fax:'.. _ — - -City: Poit'St. Lucie:........ :.: .. _._= State:FL
Phone-No. 17701 — 16 -6L,5-7 Zip Code: 34986 Fax:
E-Mail: Phone No. 772-940-4373
Fill in fee simple Title Holder on next page(if different E-Mail' justchillinair@hotmail.com
, .
from the Owner listed above). State or Coun•ty'License: 26326
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 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
commencing work or recording our Notice of Commencement.
Sig ature ofOwner/Agent/Lessee Sig atur�ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �' �J�i� i COUNTYOF
The forgoing instrurpent w acknowled ed efore me The for oing instr ment ,as acknowledged before me
this day of 20 by this�day of 20 by
(Name of person acknowled ing) (Name of person acknowledgin .)
c9—
(Signature of Notary Public-State oT Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification IX' Personally Known OR Produced Identification
Type of Identification Produc d e of identification Produced_ .
" KAREN S. NIELSEIS
Commission No. _ `�'__(Stsymission k FF 1156 7Co mission No.
.:
°. My Commission ExpirE s �,a�a;';;'•,� KAREN S. NIELSEN
�'�''�°,��;•�'� June 12, 2018. :
:.°. ' Commission N FF 115637
My Commission Expires
Revised 07/15/2014 ''�;? June 12, 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED