HomeMy WebLinkAboutBuilding Permit Application 01/04/2017 13:31 772-567-5290 JIM ROTT HOME IMP AC PAGE 01
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: V
.,.,• r.. �, iar:,W RECEIVE®
li
Bu ildtn Permit Application� pp tion
JAN 0 4 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34.982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential yes
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
1.. ' l:i .¢'1 .4,z,� 'fit, � j•,• 4&'! 1���:'.c i �i; �iiia��f)":
Address: 8204 Coquina Avenue
Legal Description: Lakewood Park-Unit 8-BLK 92 Lots(Map 13/02N)
Property Tax ID#: 1301-608-0111.000-4 Lot No.
Site Plan Name: Block No. 92
Project Name:
Setbacks Front Back: Right Side: Left Side:
v f 11 + IsF kr ' 11 •.
SiE+fS
01111111,16,61 � ifs,. .1• i{ .�h 1 t;If .i
A/C Changeout ce-1, l `
Condenser Model: YFE36B21.S
Air Handler Model: AE36BX21 3 TM
8KW heater
Em".
L1141
114
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P[ Jona work to a performed d un er is permit—c ee appy:
HVAC �Gas Tank FGas Piping _Shutters Windows/Doors
Electric �Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 4,075 Utilities:Sewer[]Septic Building Height:
1}ji31'?flll
NNEW :i.k i 'R. ii7 �'� �' ICY. v,i::.Y)9•,ii:.>'�
Name Judith Keyser Name- Kevin Rott
Address:8204 Coquina Lane Company: Jim Rott Home Improvements 8k Air Conditioning
City: Fort Pierce State:FL Address: 603 3rd Place
Zip Code: 32951 Fax, City_ Vero Beach State;FL
Phone No.772-979-5249 Zip Code: 32962 Fax: 772-567-5290
E-Mail: Phone No. 772-567-7462
Fill in fee simple Title Molder on next page(if different E-Mail: bobbie@jimrott.com
from the Owner listed above) State or County License: CA0058640
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
01/04/2017 13:31 772-567-5290 JIM ROTT HOME IMP AC PAGE 02
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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 certifythat 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 I'lorida 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
commencin work or recording our Notice of Commencement.
A-U.Z;r, 0 e , s
Signature of own Lessee/Contractor as Agent for Owner Signature of Cont for/License Holder
STATE OF FLORIDA STATE OF FLOR,IDA lYy'Filt 123 VA KCOUNTY OF tnr�.
j
COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_day of 20 J_by this_day of 20 _by
1 u &mV jwry1, P'�& ---_ -
(Name of person acknowledging) (Name of person acknowledging)
J Yn 00- �jfj -
(Sig a re of N Lary Public-State of Florida) (Si n ture of Notary Public-State of Florida)
Personally Known ✓ OR Produced Identification --- Personally Known " OR Produced identification
Type of Identification Produced r- Type of identification Produced
Commission No. fission No.
l-F 2 ZZ5� ;�' Jennifer M RIMAmffv w F=E Z 5 Z 4 r IN jwnifer RieWOnd
Revised 07/15/20-14
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
PATE
COMPLETE
INITIALS