HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
- �
RECEIVED
Building Permit Application APR 0 5 2018
Planning and Development Services ST, Lucie county, Permitting
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: 8117 Kiawah Trce Port St. Lucie, FL 34986
Legal Description: POD 25 AT THE RESERVE LOT 6(OR 4098-610)
Property Tax ID#: 3327-705-0007-000-6 Lot No.
Site Plan Name: Block No.
Project Name: PIERCE, ROBERT A/C change out
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Removing the old 2 A/C systems and installing similar systems. An exact change out
S V--e---1*a— t 6, 0 T-o v` 6 0 A��er
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
�✓ HVAC 11 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 12,350.00 Utilities:cnSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name PIERCE, ROBERT Name: Matthew Kuntz
Address:8117 Kiawah Trce Company: Jupiter-Tequesta Air Conditioning
City: Port St. Lucie State:Fl Address: 582 North US Hwy 1
Zip Code: 34986 Fax: City: Tequesta State:FI
Phone No.517-881-0592 Zip Code: 33469 Fax: 561-290-6310
E-Mail: Phone No. 561-838-3413
Fill in fee simple Title Holder on next page( if different E-Mail: acpermits @yahoo.com
from the Owner listed above) State or County License: CAC1816615
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: _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 attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA1- STATE OF FLORIDA &f\-k
COUNTY OF (&\A- � Ch COUNTYOF _
The forgoing instrument was acknowledged before me The f�o going instr is acknowledg efore me
-I— �
this day of�—� 20�by this " C—dt
ay of L 1 20M by
Name of pers n making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Iden : Type of Identificatio
"�""`
Produced �� = ST Produced
'= MY COMMISSIONSSRATH
# .7STEPHANIE KUSSRATH
�,. EXPIRES November 21,2020 ''' MISSION#
', GG0493
(Signature of Notary Public-State o or (Signature of Nota lic-State of F oricQS�mber 21,2020
Commission No.N()J TJ Yhfb (Seal) Commission No.P'SQ U 2.1 7-02!0 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17