HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ILO
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Date: 08/09/2016 Permit Number: I lO I O,ftw *
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1,2 Building Permit Application OCT 12 2016
Planning and Development Services F'ERN11TTi1'-%1G
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSE® IIVIPROVEII%IENT LOCATIQNI r5` h
Address: 3013 EAGLES NEST WAY
Legal Description. EAGLES RETREAT AT SAVANNA CLUB
Property Tax ID#: 3424-702-0209-000-1 Lot No.
Site Plan Name: Block No.
Project Name: DIANE DOSS-HUNT
Setbacks Front Back: Right Side: Left Side:
pETAIL�D DESCRIPTIO>N=OF WORK � }� }���r� '
A/C CHANGE-OUT OF A 4 TON TRANE UNIT
CONSTRUCTIONINORMATIOJ:� �.
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Additionalwork toe e orme under this permit—check a appy:
❑✓_HVAC Ej Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: S . Ft, of First Floor:
Cost of Construction: ,�-�� Utilities: Sewer[]Septic Building Height:
OUVNER/LESSEE �`� il" 1211
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NameJA— Name. GRETA B. SMITH
Address:3013 EAGLES NEST WAY Company: ALL YEAR COOLING & HEATING
City: SAINT LUCIE COUNTY State:FL Address: 1345 NE 4TH
Zip Code: 34952 Fax: City: FORT LAUDERDALE State:FL
Phone No. Zip Code: 33304 Fax: 954-617-3798
E-Mail: Phone No. 954-566-4644
Fill in fee simple Title Holder on next page (if different E-Mail: DDANIELS@AYCAIR.COM
from the Owner listed above) State or County License: CAC058160
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTI NLIENlLAU1/ INFORMATIaN I
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 attorn before
commencing work or recording our Notice of Commencement.
s
—SigrEOF
of Owner/Lessee/Agent -Signature of Contractor Ice a Hol r
STAFLORIDASTATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY COUNTY OFBROWARD
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_day of OCTOBER 20 16by this day of OCTOBER 120 16 by
DIANE DOSS GRETA B.SMITH
(Name of person acknowl (Name of perso cknowledging)
DIMITRIUS A DANT S
46, DIMITRIUS A DANIE °� B°�
MY COMMISSION#FF MY COMMISSION#FF1 71126
(Signature of Notary Pub '&,T-bf FI S October 30,tot Signature of Notary Public-St ii@-
.q la XP1RES October 30,2 8
)3BB-0153 FloridallotaryServlce.com (407)398 153 Florida"otaryService.co
Personally Known OR Produced Identification ersonally Known OR Ic I
Type of Identification Produced Type of Identification Produced
Commission No. FF173126 (Seal) Commission No. FF173126 (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS