HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: o�
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MINWINISIM
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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
tPROfPOSED]
OVEMENT LOCATION #„ ;
Address: 7420 S OCEAN DR 813 JENSEN BEACH FL 33495
Legal Description: SAND DOLLAR VILLAS CONDOMINIUM C-UNIT 613 AND UND PRO-RATA SHAREIN COMMON ELEMENTS(OR 4078-1709)
PropertyTax.ID#: 3522-604-0044-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
ya-. Yn'.
DETAILED DESCRIPTION OF WORK
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CHANGE OUT 2 TON SYSTEM WITH NEW 2 TON SYSTEM AMERICAN STANDARD
4A7A4024k000ACONDENSER/TMM4A0245215AAIR HANDLER 2— ra,..J /bra ,SeeC
CONSTRUCTION INFORMATION
Earp,
Additional work to e—e orme under this permit–check a _appy:
HVAC be
QGas Piping Shutters QWindows Doors
QElectric 1:1 Plumbing Sprinklers Q Generator Q Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 4,698.00 Utilities: Sewer Septic Building Height:
OVI7NER%LESSEE CONTRACTOR: r
Name Fernando Lewano Name: SIMON LACHANCE JR
Address:119 Kapok CRIES Company: DOVE AIR CONDITIONING&REFRIGERATION
City: Royal Palm Beach, FL 33411-4746 State:_ Address: 2581 jUPITER PARK DR F10
Zip Code: Fax: City: JUPITER State:FL
Phone No.772-675-8937 Zip Code: 33458 Fax: 561-747-1228
E-Mail: Phone No. 561-746-3757
Fill in fee simple Title Holder on next page(if different E-Mail: SIMON.LACHANCE@DOVEAC.COM
from the Owner listed above) State or County License: CACO 57001
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
N a me:Femando Lezcano Name:SIMON LACHANCE JR
Address:7420 S OCEAN DR 813 JENSEN BEACH FL 33495 Address: 119 Kapok CRES
City: Royal Palm Beach,FL 33411-4746 State: City: JUPITER State:.
Zip: Phone Zip: Phone:
FEE SIMPLE,TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2581 jUPITER PARK DR F10 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 firs pection. If you intend tLoqobtaiin financing, consult with lender or an attorney before
commencipg'wjaf k or recording o o ' of ommencement.
Si ature of 0 ner/Les /Contractor as Adedtr O er Signature of C ntrac or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Skn, COUNTY OF S�-, ,
The for oing instr ent was acknowledged before me The forgoing instrument was acknowledg d before me
this day of 20 I�' by this day of 20-Lb 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
Produc Produc d
(Si to f Notary Public-State of lioricla) nat re 6711otary Public-Stat f Florida)
Commission No. (Seal) Commission No. (Seal.
�,, ,,, SHAHNA INGRAM LASHAHNA INGRAM
.�'iP�y`�B� I State of Florida a�!'� State of Florida
otar Pubic ,o`,a ve', , v Public ,
;My Comm.Ea ices Uec o =_¢ ¢ My Comm.E.Plres 7'4
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CO Y' ;,;;�`'�RF�bh�Whtough�latiEVj€ .. -'.� REVIEW REVIEW ",;; �f�' Vdthrou hNa
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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