HomeMy WebLinkAboutBuilding Permit Application 1011212016 15:13 f AX) P.0021004
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED tt
Date: ��' �' I Lo Permit Number:
EC
Building Permit Application OCT 1"2 .2016
Planning and Development services
8ullding and Code Regulation-Division P1ERMITTING'
5t. Lucie Coun , FL
23001ilrglnla Avenue,Fort Pierce FL 34982 � ty,
Phone:(7.72)462-1553 Fax:(772)462-1578 Commercial Residential.XXX
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:'
Address: 35 Mediterranean Blvd W
Legal Description:
RropertyTax ID#: 3414-501-1701-0009 Lot No'.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
'DETAILED DESCRIPTION OF WORK:
HVAC change out only; 2.5ton 14seer system, 7.5kw
CONSTRUCTION INFORMATION:
AclaitionalworKtolenerrormed undef this perm —cneCK all IM appy:.
Z✓, HVAC Gas Tank [:]Gas Piping _Shutters 1_.1 Wlndows/Doors
Electric q Generator,
Roof Roof pitch
Total Sq.Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 4100.00' . Utllltles Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Richard Amidon Name: Scott Gamire
Address:35 Mediterranean_ Blvd West Company: AC Advantage Inc
City: Port St Lucie State:FL Address: 1926 SW Biltmore St
Zip Code: 34952 Fax: City: Port St Lucie State:FL
Phone No. Zip Code: 34984 Fax: 772-336-7566
E-Mail: Phone No. 772-336-7366
Fill In fee simple Title'Holder on next page(if different E-Mail: csr0acadvantagelnc.com
from the owner listed above) State or County License: CMC1249807
If value of construction is$2500 or more,a RECORD40 Notice of Commencement is required.
10/1312016 07:31 (FAX) P.0021002
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: _Not Appllcable MORTGAGE COMPANY: _Not Applicable.
Name: Name:
Address: Address:
City. State: City: State.,
zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Appllcable BONDING COMPANY: _Not Applicable
Name: Name: '
Address: Address:
Ctty: 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,bylawsqr and covenants that may re trict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions whit may apply.
In consideration of the granting•of this requested permit,i do hereby agree that I will,ln'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 concurtency review:room additions,.
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your'fallure 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
comm4ncingNork or recording our Notice of Commencement.
t s
n ture of Owner/Lessee/Contractor as Agent for Owner Signature o Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA.
COUNTY OF scwde COUNTY OF a'
The for ding instrument as acknowledged-before me The forgoing Instrument was acknowledged before me
'thlsZ day of 201 by tW;6'k 'day of 20 1(,0 by
ScoBCamlrs YY'L L i,, .
.(Name of person ackno ging) (Name of person acknowled )
(Sign ure of Notary ublic-State of Florlda) ( ignatur •of Notary.Pub c-State of Florida)'
Personally Known xxx OR Produced Identification Personally Known xxx .OR Produced Identification
Type of identification Produced Type of Identiflcatlon Produced
Commission No. 1`1`172262 (Seal) Jff*J mission No. FF'mGz (Seal)
NOT YPUBLIC
OF FLORIDA
Revised 07/15/2014 � �#FF772=
Expires 10/28/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE• MANGROVE
COUNTER 'REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS