HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: � FJ /• !J"�"
•
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
PROPOSED IMPROVEMENT LOCATION:
Address: 7692 Charleston Way
Legal Description: RESERVE PLANTATION-PHASE I- LOT 27 (OR 3887-1058,1060)
Property Tax ID#: 3321-801-0027-000-9 Lot No.27
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check a appy:
HVAC Gas Tank F_JGas Piping _Shutters Q Windows/Doors
0 Electric 0 Plumbing ❑Sprinklers E]Generator E] Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ UtilitiesSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR'
NameSTEVE COURTRIGHT Name: CLEMENS BASTOS
Address:7692 CHARLESTON WAY Company: DHS COOLING CORP
City: PORT SAINT LUCIE State:FL Address: 17937 VILLA CLUB WAY
Zip Code: 34986 Fax: City: BOCA RATON State:FL
Phone No. Zip Code: 33496 Fax:
E-Mail: Phone No. (561)305-0978
Fill in fee simple Title Holder on next page(if different E-Mail: DHSCOOLING@GMAIL.COM
from the Owner listed above) State or County License: CACI 818619
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 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 woxLor rjecorlding Vour Notice of Commencement.
1 N
s
Signature of O er/Lessee ontractor as Agent for Owner Signature n or/License Holder
STATE OF FLORI STATE OF FLORI A
COUNTY OF '� COUNTY OF
The f oing ins ument was acknowledg before me The forgoing instr, ent was acknowledgedt
efore me
this day o i 20� by this day of 20 by
(Name of person acknowledgin (Name of per,on acknowledging)
(Signature of Notary Public-Sta#of Florida) 1 / (Sign o Notary Public-State of Florida)
Personally Known OR Pr uc d Identification v Personally Known OR Produced entifi ation V
Type of Identification Prod u Type of Identificati axced
.Pf/''• DONNA M.MALOY •�S�`RY PVA,
=g• �, �_� JULIET
Commission No. MYCOM( II#EE 846512 Commission No. ° a�: (($ RER
EXPIRES:February 19,2017 =•. °,E Wary PubI1C-State of Florlid
SRI�yge' Bonded7hruNotaryPubllcUnderwriters :�ql oP My Comm.Expires Dec 7,20
,e
VP 45610
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS