HomeMy WebLinkAboutBuilding Permit Application 0111712017 09:02 TAX) P.0021004
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
y _ RCE!': 0 JAN 17 79`17
Building Permit Application
Planning.and development Services ,
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34992
Phone:(772)462-1553 Fax:(772)4621578 Commercial ReSidential XXx
PtRMITAPPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 1205 Australian Ave
Legal Description:
Property Tax ID#: 2433-801-0045-000-2 Lot No.
Site Plan Name: Block No.
Project Name;
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC change out only Lennox 5ton package unit 11{
CONSTRUCTION INFORMATION:
Aciditional work to lo rformed- uncler this permit—cneCK all I=appy:
HVAC Gas Tank ❑Gas Piping Shutters []Windows/Doors
11 Electric 0 Plumbing Sprinklers 11 Generator �Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 5148,00 Utilitiest Sewer U Septic Building Height:
OWN ER/LLSSEE: CONTRACTOR:
Name Janet Power Name: Scott Camlre
Address..2301 River Hammock Lane Company AC Advantage Inc
City Ft Pierce _ State:FI Address: 1926 SW Biltmore St
Zip Code: 34981 _ Fax: City: PSLucie State:FI
Phone No. Zip Code: 34984 Fax: 772-336-7566
E-mail: Phone No. 772-336-7366
Fill In fee simple Title Holder on next page(If different E_Mall: csr@acadvantageinc.com
from the Owner listed above) State or County License: CMC1249807
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required,
0111712017 09:02 TAX) P.0031004
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name; Name:
Address: Address:
City: State: City; __ _ State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: _ _ Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.L.Ve County makes no rep resenr�t tion that Is granting a permit will authorize the ermIt holder to build the subject structure
which is in conflict with any appllcab�a Home Owners Association rules,bylaws or an covenants that may re$tr(ct or prohibit such
structure.Please consult with your Home Owners Association and review your deed or 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.Lucle 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)obsite
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.
�r16�// �'l✓L.�'L. 5
ature of Owner/Lessee/Contractor as Agent for Owner Signa a of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF l.A(_Ci COUNTY OF U&CA
The forgoing Instrument was acknowledged before me The forgoing instrument was acknowledged before me
this l`, day of (Ta-r-\ , 20 1gby this j,day of ZG7_V1 .20 j4 by
scoff Scott Scott camp
(Name of person ackndging) (Name of person ackpowledg gY
QVU4QV
ure of Nota Pyblic-State of Florida) ?(Snatre of Notary Publ c-State of Florida
Personally Known xxx OR Produced Identification ally Known AcA OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF172262 J40100ma. Commission No. FF172262 lama
NOTARY PUBLIC NOTARY PUBLIC
Revised 07/15/2014 Ca FF1 62 C&MW FF1
EVIres 90/26/2018 E><plroai 10/,28/2018
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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