HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/09/16 Permit dumber:
4 J -
qwm 1, 11 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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 256 BERMUDA BEACH DRIVE
Legal Description:
Property Tax 1D#: 1425-701-0078-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LIKE FOE LIKE CHANGEOUT
3.5 TON 16 SEER 8 KIN
ti
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TION INFORMATION:
ore'to e er orme un er t �1 permit_c 11'cK 1app y:
HVAC Gas Tank E]Gas Piping Shutters Windows Doors
1 J Electric ❑ Plumbing OSprinklers []Generator �Roof Roof pitch
Total Sq. Ft of Construction; S of First Floor:
Cost of Construction: $ 6059.00 Utilities]]Sewer❑Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name BERMUDA BEACH LLC Name: CHRIS LANGEL
Address:1765 COMMERCE AVE Company: SEA COAST A/C
City: VERA BEACH State:FL Address: 3168 INDUSTRAIL 31st ST
Zip Code: 32960 Fax: Cit FT PIERCE
y� State:FL
Phone d0 401-742-9999 Ur% Za Zip Code: 34946 Fax: 466-3053
E-Mail: Phone No. 466-2400
Fill in fee simple Title Holder on next page(if different E-Mail: BAN ISEACOASTAIR a@AOL.COM
from the Owner listed above) State or County License:
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.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDAo �� STATE OF FLORIDA
COUNTY OF r COUNTY OF !_,
The f oing instrwnent Vas acknowledged before me The forgoing instrument was acknowledged before me
this day of LXaQf 20 �Lby this_01-day of V , 201_(a__by
1
� Lzi S '"Iti
(Name of person cknowledging} (Name of person acknowledging)
JA 1A I
A I AIA_ C)4'a
igna ure of Notary Public State of Florida} (Signature of Notary Public-State of Florida }
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
114
Commission No. ��IV'M� 8��1�g59 Commission No. (Seal
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Revised 07/15/2014 '11.0 Fw aM1 EXPIRES FebnFary 16,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS