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Date: 1 ' (p• 17 Permit Number: ( 070 7 00 ? D
Building Permit Application JUL a 201?
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: Other
PROPOSED IMPROVEMENT LOCATION
Address: 9628 Enclave Circle, Port St. Lucie, FL 34986
Legal Description: Enclave at the Reserve Lot 8
Property Tax ID#: 3322-800-0011-000-4 Lot No.8
Site Plan Name: Block No.
Project Name: AC change out
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC change out like for like 1 1/2 ton, Carrier, 15 SEER unit, Condenser 24 ACC418A003, Air Handler
F134CNP0181_00, 5 KW heat. C.11)Y, r I9 t
CONSTRUCTION INFORMATION:
AClaitional work toe e orme under this permit—check a appy:
HVAC 11 Gas Tank ❑Gas Piping _Shutters R Windows/Doors
Electric El Plumbing []Sprinklers I Generator 0 Roof Roof pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 3000.00 Utilities:Sewer 0 Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Doug Goschke Name: Keith Thompson
Address:9628 Enclave Circle Company: AC Keith Inc.
City: Port St. Lucie State:FL Address: 690 SW Pueblo Terrace
Zip Code: 34986 Fax:n/a City: Port St. LucieState:FL
Phone No.772-201-7364 Zip Code: 34953 Fax: n/a
E-Mail: Phone No. 772-519-1351
Fill in fee simple Title Holder on next page(if different E-Mail: ackeithl@aft.net
from the Owner listed above) State or County License: CAC1813976
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 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 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
commencioR
/w//��ork or recpyding your Notice of Commencement.
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gnature of-Owner/Lessee tractor s Agent fo `t Sign re of Contractor/License Hold =r: y't
STATE OF FLORIDA o STATE OF FLORID - o
COUNTY OF a "' ` COUNTY OF `
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The forgoing instr m nt was acknowledged,befor "'cot') The forgoing instr t was acknowledged before me m)TTI
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ED
this day of 20 ((by this 6 day of 20 Z by �}y�}7E �c
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(Name of person acknowledging) f person acknowledging) ^'
(Signature of No Public-State of Florida) (Signature of Nota P blic- ate of Florida)
Personally Known - o uced Id ntification Personally Known 01 r ed Iden ification
Type of Identification Produced Type of Identification Produced 4"_
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS