HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO,BE ACCEPTED "
Date: 12/6/2016 Permit Number: I(�
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 COCY mercial Residential X
PERMIT APPLICATION FOR: Mechanical
PR,OPOSfD,-IMPROVEMENTLOCATION-
Address: 7904 Hibiscus Rd, Fort.Pierce FL 34951
Legal Description:
Property Tax ID#: ;1301-605-0207-000-5 Lot No.
Site Plan Name::'. Block No.
Project Name:
Setbacks Front Back: Right Side: Left Sider
DETAILED DESCRIPTION OF WORK ,
Changeout of a 3-1/2 ton straight cool system with.10 kW electric heat, 15 SEER; like for like
CONSTRUCTION INFORMATION
Additional work toe e orme under this permit—c ec a appy:
�✓ HVAC Ej Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3200 Utilities:11 Sewer Septic " Building-Height:
OWNER%LESSEE CONTRACTOR z ,E 65
Name Terry Blum Name: James J Wauters
Address:7904 Hibiscus Rd Company: Just Chillin' HVAC LLC
City: Fort Pierce State:FL Address: 5422 NW Cromey St
Zip Code: 34951 Fax: City; Port-St."Lucie State:FL
Phone No.772-979-6192 Zip Code: 34986 Fax:
E-Mail: Phone No. 772-940-4373
Fill in fee simple Title Holder on next page(if different_ E-Mail:justchillinair@hotmail.com
from the Owner listed above) State or County License: 26326
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S,UPPLEMENTALZONSTRU, ION LIEN LAW INFORMATION
.. _ MORTGAGE COMPANY: - _N
DESIGNER ENGINEER: � Not Applicable of 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.
Sig ature of ner/Agent/Lessee S' nature of ontractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF L Uc), e COUNTY OF
The f oin instr nt was acknowled ed���aefore me The forgoing instr ment was acknowledge efore me
this�day of_ . 20 Eby this Jiday of IF 20by
(Name of person acknowledging) (Name of person acknowledging)
�` 11
(Signature of Nota ublic-State of Florida) (Signature ofNo#y Public-State of Florida
Personally Known rodu a Identification. Per Wally Known If ro ce
on-Prg4d Type of Identificati "° '
?64, :�a s
Notary Public-State of Florida #'E Comm! sion FF 234730
Commission No. si_'= �: Com $��#FF 234 Commission No. ` ="" `fie: My Comm �. s May 27,2019
730 �' t ` `'
u 'lFOF F�oa°c' My Comm.Expires May 27;2019 Bonded through National Notary Assn.
.. 'NuLwyAssn.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEWREVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED