HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/06/2017 Permit Number:
•
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 Commercial X Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION: I
Address:
Legal Description: 12 35 39 W 102.4 FT OF E 135.4 FT OF S 22.8 FT OF N 261.5 FT OF E 1/2 OF
NE 1/4 OF NE 1/4 OF SE 1/4- LESS AS IN ORD TAKING CA #82-131-05- (0.46 AC) (OR 572-515)
Property Tax ID #: 2312-411-0001-000-3 Lot No.
Site Plan Name:
Project Name: TREASURE COAST STEAK CO
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Block No.
INSTALLATION OF LIKE FOR LIKE 10 TON TRANE A/C SYSTEM WITH ELECTRIC HEAT
CONSTRUCTION INFORMATION:
nal work to be nertormed under
VA C Gas Tank
ectric 0 Plumbing
this permit - check all appy:
[]Gas Piping _ Shutters
Sprinklers Generator
F—]
Windows/Doors
Roof = Roof pitch
FI
Total Sq. Ft of Construction:
Cost of Construction: $ 7,398.00
SFt. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: JAMES [- 6HIMES
Company:
Address:
City: F State: _
Zip Code: 34947 Fax:
Phone No 772-45T-097
Address:
City: FOR State: FL
Zip Code: 34946 Fax: -461-8722-
Phone N—
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: K
State or County License: RA001 8071
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable
MORTGAGE COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
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 antl 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 recoE4Lnayour Notice of Commencement.
(_ s
SJFfature of Owner/Lessee/Contractor as Agent for Owner
ignature of Contractor/License Holder
STATE OF FLORIDA
COUNTYOF
STATE OF FLORIDA .
S'T
COUNTYOF LirC/�
The for o. instrument was acknowledged b fore me
thIs.&t?7rdayof
The forgoi g instrument was acknowledged before me
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this y of z5idA 20 & by
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(Name of person acknowledging)
(Name of person acknowledging)
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gnature of Notary Public- State of Florida)
Aignature of Notary Public- State of Florida )
Personal) Known OR Produced Identification
Type of Identificat Produced
Personal) Known OR Produced identification
Type "
n
of Identifica n Produced
Commission No. (Seal) SANDRA HOHMANN
mission No. (ea
Notary Public -Stale of Flo
" SANDRA HOHMANN
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Revised 47/i5/2014 Fo, G'�P Commission # FF 071680
Bontled Through National Notary
Commission # FF 071680
Or.... sir ational Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION SEATURT.E MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS