HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
i
- �- 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
x
PERMIT APPLICATION FOR: Mechanical I
I PROPOSED IMPROVEMENT LOGsATION: I
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name: 2=e�4 h0a CX
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Replacing A/C, exact change out, no duct work with 58C -emS
a 4 -On 'R.VN1zP_m 1A Semc ,� K� S�pi .t k A) C
sQASk f'm5
aamflndi wVrK EU rye IRMIUMMU
HVAC Gas Tank
unser Lnis permu—CnecK du
❑Gas Piping
apply:
Shutters
❑
Windows/Doors
Company: American Residential Services
City: , e_ State: EL
_
C��
Zip Code: 0Aq Fax:
ods
City: Vero Beach State: FIL
❑Electric OPlumbing
❑Sprinklers
❑Generator
❑Roof
Fill in fee simple Title Holder on next page (if different
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ �' Utilities:0Sewer ❑Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: Zacek, Dennis
Address: _ cfa fAS"b_A)COrA �'('
Company: American Residential Services
City: , e_ State: EL
Address: 2800 US Hwy 1
C��
Zip Code: 0Aq Fax:
ods
City: Vero Beach State: FIL
Phone No. "7.77- - I Q��
Zip Code: 32960 Fax: 772 794-9783
E -Mail:
Phone No. 772 794-7221
Fill in fee simple Title Holder on next page (if different
E -Mail: bderby@ars.com
from the Owner listed above)
State or County License: CMC1249753
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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
commencing work or recording vour Notice of Commencement.
Dkr�wr.h '- L s
_ Signature of Ow r/ Lessee/AS enr Signature of Cont or/License Holder
STATE OF FLORIDA
COUNTY OF sr.L„de
The for Ing instrument was acknowled a before me
this day of 2001by
Dennis Zacek
(Name of person acknowledging
Notary Public- StateA Florida )
Personally Known ng Pr dimed idpritifiration
Type of IdentificatioF
Commission No. Fr
'= MY COM ISSION # i F22Q97D
fXPI rll15 2019
Wryju'`3 Florida Ncra-v9e-wrw :.
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF SIL—
The forgoing instrument was acknowledge before me
this ]q day of 20 1LQ by
Dennis Zack
(Name of person acknowledging)
(Sig�ia'ture of Notary Public- State of F f�o rida )
Personally Known x OR Produced Identification
Type of Identification Produ a ...
IE
Commission No. FF220930 : MYIIHADERBY
y .. l55lON # FF�20930
"p" ESq
Iorpallo aps. m' rcm
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
Property Identification
Site Address.
Parcel ID:
Account #:
Map ID.
Use Type:
Zoning-
City/County-
ownership
oning-City/County:
Ownership
lose Renleria
Guillermina Renteria
117 Garden AVE
Fort Pierce, FL 34982-3408
Legal Description
LAKEWOOD PARK -UNIT 12-A- 13LK 173S 93 FT OF LOT 15 (MAP
13/13N) (OR 3866-1663)
Current Values
Just/Market Value_ 539,200
Assessed Value: $31,570
Exemptions: s0
Taxable Value. 531,570
Taxes for this parcel: SLC Tax Collector's Office 12
Download TRIM for this parcel. Download PDF 12
5003 I-ASTWOOD DR
1301-615-0123-000-3
3764
13 13
0800
RM -5
Saint Lucie County
Total Areas
Fintshed/Under Air (SF): 1.560
Gross Area (SF): 2,440
Land Size (acres): 0.26
Land Size (SF): 11.344
This information is believed to be correct at this time but it is subject to change and is not warranted.
® Copyright 2016 Saint Lucie County Property Appraiser. All rights reserved.