HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
I
PROPOSED IMPROVEMENT LOCATION:
Address: 8171 13TH InOLE DR
Legal Description: LINKS AT SAVANNA CLUB (PB 40-39) BLK 35 LOT 20 (OR 3218-690)
Property Tax ID #: 3425-707-0078-000-1 1 Lot No.
Site Plan Name: Account #: 148045 Map ID: 34/25S Use Type: 0200Zoning: PUDJurisdiction: Saint Lucie County Block No.
Project Name:
Setbacks Front Back
Right Side: Left Side:
REPLACE CENTRAL AIR 4 TON CHAMPION PACKAGE UNIT WITH 10 KW HEAT.
CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit— check a appy:
✓HVAC ffGasTank ❑Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers 0 Generator I] Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 4200 UtilitiescnSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name PAULOVE DALSGAARD
Name: A/C DOCTORS INC
Address: 8171 13th hole Dr
Company: A/C DOCTORS INC
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No. 7723807519
Address: 1853 NW BILTMORE ST
City: PORT ST LUCIE State: FL
Zip Code: 34983 Fax:
Phone No. 7723443944
E -Mail: poulove@msn.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: ACDOCTORSINC@GMAIL.COM,
State or County License: CAC058461
If value of construction is S2s00 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name: PAULOVE DALSGAARD
MORTGAGE COMPANY: _ Not Applicable
Name: A/C DOCTORS INC
Ad d reSS: 8171 13TH hOLE DR
Address: 8171 13th hole or
City: PORTSTLUCIE State:
Zip: Phone
City: PORTSTLUCIE State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Ad d rens: 1853 NN BILTMORE ST
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 contlict 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 pro erty. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspecti . If you tend to obtain financing, consult with lender or attorney before
commencingw rk or Cor ' our Notice of Commencement.
Signat e o er/ Lessee/Contractor as Agent for Owner
Signatur ractor/Licen
STATE OF FLO DA
STATE OF FLORI
COUNTY OF 6LAKj
COUNTY OF�r
The f�..,,o,rP�Qing instru en was acknowledged before me
The f a�pp.i,ng instru ent was acknowledged before me
�'�'day
this aay of �99I , 20JI by
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Name of person making statement
Name of person making statement ✓
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Produced -Florida- L-
Type of IdeJcation
Produced
(Signature of Nofiry Public -State of Hoak)20;
(Signature of IVoYary Public -State of FWWa)
el MARYLEEMATnS
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17