HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INF MUST B COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��� DC� I�c Permit Number:
Lam,
Building Permit Application OCT 2 7 2016
Planning and Development Services PER.," ITTING
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
PERMIT APPLICATION FOR: Mechanical El
PROPOSED IMPROVEMENT LOCATION
Address: QLno&06S lr
Legal Description: I(l1JQ 1ar1 1 n S gl((6 to O
Property Tax ID#: 3J2,2. 5(X7'- 0030—(= "2 Lot No.�
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
thew t��n��S 1�-� ►ns�all���o�n in e
n(d C>t,=.J0 ti&t
CONSTRUCTION,11WORM'ATION:
Additionalworkto e e orme un er t is permit—check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing—`t Sprinklers 11 Generator 1-1 Roof
Total Sq. Ft of Construction: 11 2 7S . Ft. of First Floor:
Cost of Construction:$ 591q Utilities:�Sewer Septic Building Height:
.OWN,ER/LESSEE:.. 'CONTRACTOR:
Namecc vy r) ; Name:: Edo§assn .
4dr,,ess. a t S Ur, 'Gorrtp�n}t.''EOS Airondifioning
2200 4th'Ave'N#1
City '�t^(�Ct=' State: L ,Address-,
Zip�od`e ��G�b Fax: City:„ State.
Lake Worth r FL
Phone No. Zip Code: 33460 Fax: 561-586-0771
E-Mail: Phone No. 561-586-7090
Fill in fee simple Title Holder on next page(if different E-Mail: SLopez@edsairconditioning.com
from the Owner listed above) State or County License: CAC1815515
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 additio s,
accessory structures,swimming pools,f nces,walls,signs,screen rooms and accessory uses to another non-r identi I use
WARNING TO OWNER:Your fai r to ord a Notice of Commencement may result in your inice for
improvements to your prope N e of Commencement must be recorded and po jobsite
before the first inspection. o in d to obtain financing, consult with lender or a rnfore
commencingwork or rec o Notice of Commencement.
s
_Signature of Owner/Lessee/A nt Signature of Contractor/License er
STATE OF FLORIDA��Im Ch FLORIDA
��I�.�Ch
COUNTY OF COUNTY OF `K'
The forgoing instrum nt was acknowledged before me The forgoing instrument was acknowledged before me
this day of i— 20 110 by this day of ncC kr 20 110 by
1;� t;ffiol Isco LSC{c nC6 &&0
(Name of person acknowledging) (Name of person acknowledging)
(Signatu 4 o N taryrnR
tate of Florida ) (Signature of otaryPub State of Florida)
Personally Known Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
��22 *. Stephanie M.L - //,��,�// ,, V ,
Commission No. W dWV� a�'Coftsien#GG Commission No. l���b �* � S nle M.Lopez
Expires:June 20,2 20 _ � GG003S26
°�` •"°Expires:June 20,2020
Bonded thn- Aar '10 of Bonded thru JAMaron.No17
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS