HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/27/2017
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 Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION
Address: 9203 Wentworth Lane Port Saint Lucie, FL 34986
Legal Description: POD 20A AT THE RESERVE PUD II CASTLE PINES LOT 32 (MAP 33/27S) (OR 2212-675)
Property Tax ID #: 3327-801-0040-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Exact AC Changeout of Goodman 4 Ton 16 Seer - 10kw heater
Condenser Model: GSX16048
AH Model: ASPT49014A
CONSTRUCTION INFORMATION:
Additional work to be ertormed under
HVAC 11GasTank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4400.00
OWNER/LESSEE:
LJ Shutters
Generator
L J Windows/Doors
Roof
SFt. of First Floor:
Utilities:nSewer MSeptic Building Height:
NameJames Moran Mary Hall -Moran
Address:53 Barbara St
City: Bethpage State:NY
Zip Code: 11714 Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Donald Myers
Company: AC Care, LLC
Address: 1500 NW Federal Hwy
City: Stuart State: FL
Zip Code: 34994 Fax: 772-252-3231
Phone No. 772-266-2665
E -Mail: office@accareheatair.com
State or County License: State License #CAC1818622
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL 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 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 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 vour Notice of Comme cement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF Ma Yitlll
The for oing instrur�ot was acknowledged before me
thisiTdayof YP�1711� 20 3_-4by
nom(N 'h1' i+
Signature o�actor/License Holder
STATE OF FLORIDA r
COUNTY OF Rla.irr Lv%
The for oing instrument was acknowledged before me
thisFdayof Fey 20nby
ame o person ac now e g g (Name of person acknowledging
6
(
6te of Nota Pub ic- State of Florida) (Signature of Notaublic�- State of Florida )
Personally Known V_ OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produ _ - _ T pe of Identification P� .4 DKn I KMT l LMwCK
1IFe. BRITTNEY N IFF91 F �------� , MY CO ION Y FF956BTd
Commission No. I:' •c M��i�1M�SSION p FF9S62� mmission NO. NSA
EXPIRES Febmary 02. 2020
I' EXPIRES February 02. 200 ris.cI» ow" Hwnane+eon'
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE I MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS