HomeMy WebLinkAboutKennedy AC Change out permit pg 1 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/07/18 Permit Number:
} 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 x Residential
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 9500 S Ocean Drive Unit 901
Legal Description: Islandia II Condominium —
Property Tax ID#: 4502-602-0075-000-7 — -- — — — -- — Lot No.
Site Plan Name: Block No.
Project Name: _
Setbacks Front _ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Like for Like AC Change Water Source Heat Pump 3.5 ton 13 EER No KW
CONSTRUCTION INFORMATION:
Additional work to be i)erformed under this permit—check all that apply:
�HVAC Gas Tank Gas Piping ❑_Shutters ❑Windows/Doors
Electric ❑ Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:_
Cost of Construction: $ 2500.00 Utilities:cnSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name William J Kennedy Name: Kim Wilson
Address:31 Betts Dr Company: Premier Plumbing &Air LLC
City: Washington Crossing _State:PA Address: 108 NE Dixie Hwy —_
Zip Code: 18977 Fax: City: Stuart State:FL
Phone No. Zip Code: 34994 — Fax: 7726921094 —
E-Mail:_ _ _ Phone No. 7726922500
Fill in fee simple Title Holder on next page ( if different E-Mail: preplbgac@gmail.com —from the Owner listed above) State or County License: 25222
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:William J Kennedy Name:Kim Wilson
Add ress:9500 S Ocean Drive Unit 901 Address: 31 Betts Dr
- ---- - - ----- -- --
City: Washington Crossing State: City: Stuart State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:_
Address:108 NE Dixie Hwy 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 FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF _
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this__day of_ 20 by this day of 20__ by
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
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
Commission No. _ (Seal) 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