HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04102/201/ Permit Number:
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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 0
PROPOSED IMPROVEMENT LOCATION:
Address: 7400 Laurels Place ,Port Saint Lucie , FL 34886
Legal Description: Parcel 15A AT THE PERSERVE LOT (OR 3619-2314)
Property Tax ID #: 3322-501-0021-000-9
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.18
Block No.
A/C Change Out ,Install Rheem 2.5Ton ,16Seer ,5KW Heater,S/C Split System ,LIKE FOR LIKE
CONSTRUCTION INFORMATION:
A �tiona wor toewe Orme u -n er t is permst — c ec a appy:
❑✓ HVAC II �_il Gas Tank
—]Gas Piping Shutters a Win[iows/Doors
Electric ❑ Plumbing 0Sprinklers FIGenerator F]Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 4,400.00
Sq. Ft. of First Floor: _
Utilities: 0 Sewer D Septic
Building Height:
OW N ERAESSEE:
CONTRACTOR:
Name Donna Buscema
Name: Kelly Certasimo
Address. -7400 Laurels Place
Company: Air Temp Air Conditioning,lnc.
City. Port Saint LucieState: FL
Zip Code: 34986 Fax:
Phone No.315-254-7777
Address: 651 NW Enterprise Drive #107
City: Port Saint Lucie State: FL
Zip Code: 34986 Fax:
Phone No. 772-340-0740
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: airtempac@yahoo.com
State or County License: CAC1814837
If value of construction is $2500 or more, a REULUKULU NaTiCe OT Vornrnencernent i5 rt:94UH u.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:t --
MORTGAGE COMPANY; _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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 l will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and 5t. 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 Commencement.
Rev. 8/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signatur6 of Cont ctor/License Holder
STATE OF FLORIDA
STATE OF FLORkDA
COUNTY OF f ;�I�k_k—
COUNTY OF :�
The for o n instrument was cknowlecled efore me
thisay of 1 ` 20by
The f r oing instrument was acknowled ec before me
this�day of{,� (`, 2( by
Na a of person making statement
acne of1person making statement
Personally Known OR Produced Identification
Personally Kno VVK OR Produced Identification
Type of Identification
Produced
Type of Identification
Produced
r--
Y'u Florida
.4 F14't�� Vim'
Nota Public State of
r !'°
Catherine gonna flnahan ps. l I, i
( f
.�Y'� Notary Public of Florid
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f my Commission GG t7&Sf ! .
my
? .Catherine Donna Mahan
(sign ur4i ota xp�fe� 'e- S a e o F ori
(signature ul3 reStr�m��ri a
Commission No.� (Seal}
CommissionYNa.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17