HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/29/2016 Permit Number:
-1 J 4 7
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: 1292 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-1479-000-6
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Change out 3 ton 15 seer Rheem heat pump split system J Kw heater like for like
CONSTRUCTION INFORMATION:
Additional work to e e orme un ert ispermit—c
❑HVAC n Gas Tank F]Gas Piping
11 Electric ❑ Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4200.00
OWNER/LESSEE:
Name Joanne Parkinson
Address: 1292 Nettles Blvd
City: Jensen Beach
Zip Code: 34957
Phone No_ 508-259-0258
Fax:
NV17.
_ Shutters
0 Generator
5 Ft. of First Floor: _
Utilities: Sewer [:] Septic
State: Fl
E -Mail:
Fill in fee simple Title bolder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Narna• Vance R Corbin
Lot No.
Block No.
aWindows/Doors
Roof
Building Height:
Roof pitch
Company: Dodd Enterprises inc
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: Fl
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail: doddenterprises@dodd.com
State or County License: CMC12499588
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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 Horne 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 your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ,C�`Q� - COUNTY OF
The forgoing insti-Went wa acknowledged before me
this day of 20 4by
V vtf/ L,rVr�. Vim`
(Name of person acknowledging)
Type of Identification Produced
Commission No. (Seal)
flSIC7N #FFOB1868
++, lacomber 12, 2017
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_RfViLWS FRONT ZONING
'COUNTER REVIEW
DATE r i_
COMPLETE
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The forgoing instrum t as cknowled ed before me
this day of ��2d(P_ by
(Name of person acknowledging)
(Signature of4otary Public- State of Florida )
Personally Known il"- OR Produced Identification_.
Type of Identification Produced
Commission No. (Seai)
*pY"4,•-:SUZETTE RITCHIE
. +€ My COMMISSION #FFU61868
EXPIRES December 12 2017
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SUPERVISOR PLANS VEGETATIONSEA TRTLE MANGROVE
REVIEW REVIEW REVIEW [REVUIEW
REVIEW
(Signature of Notary Pu _
c- State of Florida )
1
Personally Known
OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
flSIC7N #FFOB1868
++, lacomber 12, 2017
4407)_19iL0 153 lor 3 Q
_RfViLWS FRONT ZONING
'COUNTER REVIEW
DATE r i_
COMPLETE
--+NlthAt`S .-
The forgoing instrum t as cknowled ed before me
this day of ��2d(P_ by
(Name of person acknowledging)
(Signature of4otary Public- State of Florida )
Personally Known il"- OR Produced Identification_.
Type of Identification Produced
Commission No. (Seai)
*pY"4,•-:SUZETTE RITCHIE
. +€ My COMMISSION #FFU61868
EXPIRES December 12 2017
rvic�,coni _.
SUPERVISOR PLANS VEGETATIONSEA TRTLE MANGROVE
REVIEW REVIEW REVIEW [REVUIEW
REVIEW