HomeMy WebLinkAboutBuilding Permit Application SU3PPLEMENTAL CONSTRUCTION LIENLg1N IN, C3RMAT(01 `•
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY:; __ Not Applicable
Name: Name:
Address: Address;
City:_ _ State: City, StaCe:
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,Counfy 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 Iwill, in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
TK..e'following building permit applications are exempt from undergoing a.full concurrency review:room additions,
accessory structures,swimming pools,fences;wails,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 recordingyour Notice of Commencement.
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P. 9 (No-.1.I2Jg,2 JU10 Kll0 Christopher P Langel D0 e:10,6419ll�,:�g-05'00 S
...............,,-
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
�'he f going instC i elft was a'cka�nowledged befard me The forgoing,." Im:ent was•,atl(66wledged before:me
thl4 _.:day'of:: __ _.;t` .20. J(W' y this?.day o- � . . :._,20 � by
Cit iMfS.I ANGEL CHIRIS LANGEL
(Name of person acknowledging.) (Name of person acknowledging)
( .',nature o:fNotary Public-State of"Tlorida} (51gn3ture of'Nntary Publlt-5laie of Flc}retia)
Personally Known x OR Produced Identification... Personally Known OR Produced Identification_...........
_,,,,
Type of Identification Produced Type of Identification Produced
Commission No..FF9G1459 FF961459
_.....__.___ r (Seal)
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EX
r1'��S FatirtrarY'I MY COMMISSION ae FF961459
Revised 07/15/2014 Inu7 r t�K u� FIa�1rlaMotary3a vics,com
� V EXPIRES February 16,2020
(40713158-M3 florld Sarvka.com
,REVIEWS. FRONT ZONING SUPERVISOR FLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
nA
COMWLETE
INITIALS'
ALL APPLICABLE INFO MUST BE COMPLETED
Date: 12120116
FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL j4982
Phone: (172) 462-I5s3 Fax: (712\ 462-157B Commercial Residential x
PERMIT APPLICATIoN FoR: To Select from dropbox, click arrow at the end of tine
PROPOSED IM PROVEM ENT LOCATION :
Address: 5385 CHRISTENSEN ROAD
Legal Description:
Property Tax lD #:
Site Plan Name:
3405-700-0002-000-5 Lot No.
Block No,
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE CHANGEOUT
4 TON 16 SEER 1O KW
CONSTRUCTION INFORMATION:
tonatwor
n
T
HVAC
Electric
Gas Tank
Plu mbing
l_-leas eiping
rTtl
S h utte rs
Generato r
II Windows/Doors
Roofrl|]sprintterc
l-otalSq. Ft of Construction:Sq. Ft of First Floor:
Utilities: l-l ru*", I t"*.Cost of Construction: $ 6'1 30.00 Building Height:
OWN ER/LESSEE:CONTRACTOR:
ilr- RrrsstllFrrs Name: CHRIS LANGEL
Address: 5385 CHRISTENSEN ROAD Company: S-EA COAST A/C
rir'. FT PIERCE-,. t ' _State: FL Address: 3108 INDUSTRIAL 31st STREET
ZiP Code: 34981 Fax:citv. Fl'PIERCE State: FL _
pur. 772-466-3053phone No,a16-8.43+AS __Zip code: :1946
phone 11o. 772-466-2400
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-M ail: DAN ISEACOASTAI R@AOL COVI
State or Countv License: cMCo35421
lf value of construciiorrir Szsoo or more, a RECoRDED Notke-;tornm"ncemunt-ii-*qri*u.
BONDING COMPANY:
Name:
_Not Applicable
Ad d ress:
City:
I certify that no work or instailation has commenced prior to the issuance of a permit.
St, Lucie Countv makes no repreSentation that is granting a permit will a,uthorize the permit holder to kruild the subiect structurewhich is in conflict with any.g'pplicalj,le Hoqe owhers As5ociation rules, bvlaws or and covenanrs th;i;;Vi;iir'"i;i'p'roiif it.ucr.,structure' Please consult With your Home owners Associaiion-dnd ievi6w'yoiji,l;ed fo;;;i iesiriitirini'"r,,ifiiir''"i-'v .dpV.'"
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform l:he worl<in accordance with the approved plans, the Florida Building Codes and it. Lucie Countv 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
|]Fj:]:n.X"t:l?^v_"{-Pl9?Fttv' A Notice of ,Comm.encement must be reco'raeO una poitJa'oninu 1'ootitubefore the first inspection, lf.y6u intend to obtain finrncing, ionsult with lender or an attorn;i b.i6;;commencing work or recording your Notice of Commenceffienr.
Zip: _-:_ Phone:
Christopher P Langel Dlsilanydgrod hy ch'Elopt erp LJrse
oare:2016 1? 19 12 r1 49 {5 oO
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF ST LUCIE
CHRIS LANGEL
(Name of person acknowledging )
Revised 0711512014
Personally l(nown _ OR Produced ldentificatron
Type of ldentification Produced
n No. FF961459 (Sea l)
MANGROVE
REVIEW
DESIGNER/ENGINEER: _ Not AFpilA
Add ress:
State:Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Apolicable
Name:
Add ress:
Signature of Owner/Lessee/Contractor as Affi-for Owner
STATE OF FLORIDA
COUNTY OF srLUCIE
(Name of person acknowledging )
ature of Notary
Personally Known ]_ OR produced ldentification
Type of ldentification Produced
commission No. FFs6145s
;:: MY COMMISSION # FF961459
EXPIRES February 16, Z0Z0
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COUNTER
ZONING
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