HomeMy WebLinkAboutBuilding Permit Application 1210212016 14:17 Alt) P.0021009
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date .`a 5N Permit Number:
UCEI'.'� D DEC Q 2016
Building Permit Application
Planning and development Services
Building and Code Regulation Division
2300 Virgin to Avenue,Fort Fierce FL 34952
Phone:(772)462-1553 Fax:(772)•462-1578 Commercial xxx Residential
PERMIT APPLICATION FOR: • Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address; 8505 S US Highway 1 I'SLucie 34852
Legal Description:
PropertyTax iD 3�a6"1ro5— CSO.\y -b��' Lot No.
Site Plan Name: Block No.
Project Name;
Setbacks Front Buck: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
'HVAC change out only, 2.5 ton Lennox package unit 7kw y S 9, �-
CONSTRUCTION INFORMATION:
Additionalworl(toOPnerformed under thls perm —checkall appy:
HVAC Gas-Tank ❑Gas Piping Shutters- ❑Windows/Doors
�Eleetric 0 Plumbing Sprinklers Generator Roof . I� Roofpltch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 4083.00 Vtilities:[]Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Miller Insurance Agency c/o Michelle Miller Name: Scott Camlre
Address:8505 S US Highway.1 Company: AC Advantage Inc
City. Port St Lucie State: FI Address: 1926 SW Biltmore St
zip Code; 34952 Fax:. . City: port St Lucie State: FI
Phone No. Zip Code: 34984 Fax: 772-336-7566
E-Mail: Phone No. 772-338-7386
Fill In fee simple Title Holder on next page(If different E-Mail: csr@aeadvantageine.com
from the Owner listed above) State or County License: CMC 1249807
If value of construction is$2500 or more,a RECORDED Notice of commencement Is required.
1210212016 14:17 SAS) P.0031009
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: _ Address:
City: State: City: State:
Z.1 p: 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.Lucle'County makes no representation that Is granting a permit will authorize the permit holder to bull the subjects trut�cture
which 1s to conflict with any applicable Home Owner's Association rules,bylaws 4r and covenants that may retract or pro ibIt such
structure.Please consult with your Home Owners Association and review your deed for any restrictlons 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:roam additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-resldential 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)obsite
the first Inspection, If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
A. S
lgna ure.of Owner/Le ee Contractor as Agent for Owner' S Ts re of Contract 'cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF skwala COUNTY OF alujaw
The f• going instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of qQV . 20 Jkby •this a day of N010m°QP .20 1 RU by
Scott Clmin soon camire
(Name of person acknowl ng) (Name.of person acknowl fdgin
(Signa re of Notary Pu Ilc-State of Florida) ..,(Siature of Notary Public- tate of Florida)
Personally Ktiown xxx OR Produced identification I to y Known xx OR Produced identlflcatlon
Type-of Identification Produced Type of Identification Produced
Commission No. e4rie Pwm Commission No. FF172202 (SRa1 pom
NOTARY PUBLIC NOTARY PUBLIC
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Revised 07/15/2014 Can *FF172282 Cwm*FFi?2252
F�Ires 10/28/2018 iqm Expire$10/2812018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS