HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: &,z
- RECEIVED
Building Permit Application APR 19 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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 9200 One Putt Place, Port St. Lucie, FL 34986
Legal Description: Lakes at PGA Village
Property Tax ID#: - V Lot No.
Site Plan Name: Island Club, PGA Village POA, Inc. Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replacing Air Conditioning Lennox 2 stage unit with Carrier 2 stage unit. 5 ton, KW heat,
Condenser 24ACB760AB03, Air Handler FV4CNB006L00, 16 SEER
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all appy:
✓HVAC Gas Tank 0Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 5700.00 Utilities:0 Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name PGA Village POA Inc. Name: Keith Thompson
Address:2140 NW Reserve Park Tr. Company: AC Keith Inc.
City: Port St. Lucie State:FIL Address: 690 SW Pueblo Terrace
Zip Code: 34986 Fax: City: Port St. Lucie State:FL
Phone No.772-466-9338/631-464-5989 Zip Code: 34953 Fax:
E-Mail:islandclubadmin@langmanagement.com Phone No. 772-519-1351
Fill in fee simple Title Holder on next page(if different E-Mail: ackeithl@att.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:
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 recor 'ng your Notice of Commencement.
C � t
Signature of Owner/Lesse ontractor as Agent for Owner Si nature of ntractor/License H er
STATE OF FLORIDA / � STATE OF FLORIDA
COUNTY OF �� �L} COUNTY OF
The for oing instrument was acknowledged before me The forping instru ent was acknowledge�iJ�efore me
this_a day of �i�(1, , 20J?by this JVday of 0 20 by
lull
kee- - s c�
N e of person making statement Name of person making statement
Per ally own OR Produced Ide ' icalt ion Personally Known OR Produced Identification
Type of Id e tifl'�ation , t Type of Identification
Produced �KL(lew/��I 5e z�°� Produced U1°1s Ll(Q I{'.
C>vy Ey— Hw-AF( ign ure o otary Public-State of Florida T m Sig atur f Notary Public-State of Floridas� dCommission No. (Se Commission No.REVIEWS FRONT ZONING OR PLANS VEGETATION SEA TURTLE11 VE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17