HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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 4 4
Address: 2829 Eagles Nest Way, Port St. Lucie, FL
Legal Description: Change out of AC at Mobile home in Eagle's Retreat at Savanna Club
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Property Tax ID#: 3424-702-0198-000-0 Lot No.10
Site Plan Name: Block No. 64
Project Name:
Setbacks Front Back: Right Side: Left Side:
� DETALLED DESCRIPTION
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Change out like for like to Carrier package unit 50ZPC48, 4 ton, 14 SEER, 10 KW heat
.CONSTRUCTION INFORMATION
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Additional work to be Dertormed under this permit—check all appy:
❑✓_HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 3518.00 Utilities. Sewer❑Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Danielle Bowers Name: Keith C.Thompson
Address:39 Harts Lane Company: AC Keith Inc.
City: Walden State:NY Address: 690 Sw Pueblo Terrace
Zip Code: 12586 Fax:n/a City: Port St. Lucie State:FL
Phone No.845-656-9086 Zip Code: 34953 Fax: n/a
E-Mail: Phone No. 772-519-1351 j
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION '
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: n _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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the!work and installation as indicated.
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 attorn y before
commencin&Mork or recording our Notice of Commencement.
C'
S' nature of Owner/ es /Contractor as Agent for Owner 9.ature of Contractor/License o r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sir. J COUNTYOF
The forgoing instru ent was acknowledged before me The forgoing instr ent was acknowledged before me
this a4 day of 20a by thi;O day of 20 11 by
Name of person making st tement Name of person making stat ment
Personaffy Known OR Produced fdentrffca-d N Personally Krrmm OR Produced 1den0catrorr
Type of Identification Type of Identification
Produced ProducedL1
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(Signature of Notary Public-Stat f Florida) (Sig ure of Notary Public-St;A of Florida)
Seal
Commission No. (Seal) Commission No. HNA INOMM
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Q�Ot�Y PUBS'. WntaryPublic-State of Florida , . 3• '•E My Comm.Expires Dec 20,201
' =My Comm.Expi es Dec 20,2018 ` Commf Sion FF 177299
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17