HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State: _
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable - BONDING COMPANY: x 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 thepermit 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 your Notice of Commencement.
signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF i
The forging instrument wa knowleclgeybefore me
this day of 20 by
(Name of person acknowledging )
(Signature of Notary Public -State of Florida )
Personally Known / OR Produced Identification
Type of Identification Produced
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STATE OF FLORIDA t�"t_
COUNTY OF
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this day of _W t_ rA _, 20 *by
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;Yo Jo. SUZETTE RITCHIE
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R-EUEEW.S ' .' FONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
k DATE -
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COMPLETE
INITIALS
MANGROVE
REVIEW
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/19/2016 Permit Number:
CcKINTY
F L O !t [ D is
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 475 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0661-000-2
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front
Commercial Residential X
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out 2 1/2 ton 14 seer Payne st cool pkg unit 8 kw heater like for like
CONSTRUCTION INFORMATION:
Additional work to be oertormed under this perrnit– check allapply:
IIFIVAC Gas Tank []Gas Piping MShutters
11 Electric ❑ Plumbing Sprinklers ❑ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 3800.00
OWNER/LESSEE:
Name Susan Sibiski
Address: 475 Nettles Blvd
S Ft. of First Floor:
Utilities. — Sewer OSeptic
City: Jensen Beach State: Fl
Zip Code: 34957 Fax:
Phone N o. 410-913-6955
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Lot No.
Block No.
Windows/Doors
Roof I I Root pitch
Building Height:
CONTRACTOR:
Name: Vance R Corbin
Company: Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
City: Port St Lucie State: Fl
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail: doddenterprises@dodd.com
State or County License: CMC1249958
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.