HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -1
Date: `� 111 1� Permit Number:
• RECEIVED
Building Permit Application APR 17 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting„
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: 8 LAKE VISTA TRL 202
Legal Description:
VISTA ST LUCIE BLDG 8 UNIT 202 (OR 3574-2952)
Property Tax ID#: Parcel ID: 3422-500-0107-000-0 Lot No.
Site Plan Name: Block No.
Project Name: WERBECK,ART A/C change out
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Removing the old A/C system and installing a similar system. An exact change out
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CONSTRUCTION INFORMATION:
Additional work to ;as
orme un er t is permit-c ec a appy:
✓HVAC Tank ❑Gas Piping _Shutters Windows/Doors
11 Electric lumbing Sprinklers n Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ SG%.A y9M5.0a Utilities.Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name WERBECK,ART Name: Matthew Kuntz
Address: 8 LAKE VISTA TRL 202 Company: Jupiter-Tequesta Air Conditioning
City: Port Saint Lucie State:Fl Address: 582 North US Hwy 1
Zip Code: 34952 Fax: City: Tequesta State:FI
Phone No. 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.
1 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.
L� L�
ignature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDAP)al�� ((_mac 1 ^ STATE OF FLORIDA
COUNTY OF V r ) COUNTY OF UUP �Y1
The forgoing instrument w s acknowledg d efore me The forgoing instru tiw s acknowledged before me
this LU day of 20 by this t(S day of l 20 IRy
�u a �2 JL Y-uaz_
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
•�"''• STEPHANIE KUSSRATH 'py.p ,
STEPHANIE KUSSRATH
(Signature of Notary P •` �lovember 21,2020 (Signature of Notary epi' ¢(,�yI� SION#GG049347
o"`' EXPIRES November 21,2020
'1o:n
Commission No. Commission No. 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