HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/29/2016 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 371 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0557-000-0
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out 3 ton 14 seer Payne st cool pkg unit Skw heater like for like
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional wor to e e orme un ert �spermit—c ec
❑HVAC M FIG Piping
a appy:
Shutters Windows/Doors
Gas Tank
❑ O Sprinklers
_
Generator L�� Roof Roof pitch
L f Electric Plumbing
Total Sq. Ft of Construction:
S. of First Floor:
ElHeight:
Cost of Construction: $ 3500.00 Utilities:11
Sewer Septic Building
OWNERf LESSEE:
CONTRACTOR:
Name Susan Bean
Name: Vance R Corrin
Address: 371 Nettles Blvd
Company: Dodd Enterprises Inc
City: Jensen Beach State:Fl
Address: 1296 SE Industrial Blvd
Zip Code: 34957 Fax:
City: Port St Lucie State: FI
Phone No. 732-991-3638
Zip Cade: 34052 Fax: 335-3310
E -Mail:
Phone No. 398-2344
Fill in fee simple Title Holder on next page (if different
E -Mail: doddenterprises aodadd.com
from the Owner listed above)
State or County License: CMC1249958
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
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
City: State:
Zip; Phone:
BONDING COMPANY: x Not Applicable
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 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.
A �
Signa re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF U COUNTY OF
The f ging Instru e t wa acknowledged.before me The forgoing instru en=was.ackledged before me
this day of 20 ]by this day of20 by
(Name of person acknowledging) (Name of person acknowledging)
UL'_
(Signature of Notary Pu 'c- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
TCHII(5e
MY ,OMMISSION #kFF061868
jj
t ;
(Signature of NotVy Public- State of Florida )
Personally Known l/ OR Produced Identification
Type of Identification Produced
Commission No_ (Seal)
My GOMMI69I0N ikFFURO
#ca
.b Er;r rvn�c�r ic17
_a
{ao,7
FREVIEW5-
FRONT
ZONING
SUPERVISOR
LANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE-. _
CDI�'1PLETE
INITIALS