HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO:MUST BE COMPLETED FOR APPLICATION TO BE ACC -_.._.,L_ �/7' Y/ ►
Date: Perm t .,
E%O
JUL 1 1 2018
Building Permit Applic ion
Planning and Development Services Lpermitting Department
Building and Code Regulation Division St, Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To.Select from dropbox, click arrow at the end of line
',RaPQS ;D IN, PRaVEMEM LD 7-Tt(3'f ;
Address: X00 i'OE 50y, ACL b P0 SA i;,l aC; Q 3 _
Legal Description: fkV_'Ae dncin�,C a LJ W,� (-' C11-t- (- CODr L
Property Tax ID#: Y_0 v )3—0 010. Lot No.
Site Plan Name: E(r 7 c,(o-e_�Li IS t?ri k c'o Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D
RED a (II hTIU f`WO„
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Add
C•NSTRUCTIDN NFORiWI�IT'(ON:
i i onal wor o- e ne med under this,permi —check'a : appy:
`allVAC Gas Tank ❑Gas Piping Shutters ❑Windows/Doors
gElectric Plumbing ❑Sprinklers E Generator 11 Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ / ��_ Utilities:Sewer[]Septic Building Height.
0VVIN"1 L S E:
Name f'1 4le;w-41 Qi4-riLO Name:
Address:Qot) A)IF Seel:ac, Or- Company: P,--eealom 41 r &n d
City: Por' G� C Lc-if. State:FI Address: X101 C )
Zip Code: 3 4 3 Fax: City: Co C o State: F/
Phone No. as 8 -69 aO 334 Zip Code: 3P'10131 Fax:
E-Mail: Phone No. 3.-Di-
Fill in fee simple Title Holder on next page(if different E-Mail:G„ ire d r9 Fy eclai-,, C�+n
from the Owner listed above) State or County License: C,4c /-R/ "yY
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
5 PP -NtINTAl.CONS `R,UCTION LCEN LAW IN ORMA�TIC?N•.
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 anyapplicable 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 ofthe-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 Ir ryour 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.Qwner/Lessee/Contractoras Agent�forow�ner Signature of Contract r/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF J'f G"uG�e
The for oIng instrument was acknowledged before me• The forgoing instrument was acknowledged_before me
this: day of u J 20I by this 4�day of .Tu)y 20 by
lh,drw 11-v ndl Andrag .Pince//
Name,of person making statement Name of person makingstatement
Personally Known X OR Produced Identification Personally Known >e' OR_OR Produced Identification
Type of Identification Type of'Identification
Produced Produced
ignature of N_ u lic-State,of Florida) TRAVIS 9ATCHE DEFt'n otary Public-State of Florida)
commission No.(^l`9g270?- NOTARYPUBLIC Commission No. 9 2?02 TRAVIS 9
STATE OF FLORI ,A NOTARY- Ua;
s� o
Comm#FF992702 STATE O 1ilA
AA sti ° Exxppires 1 l2Q�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17.
FREEDOM AIR:ANDHEAT INC
1401 CLEA LWE,RD
EDlow -COCOA"FL 32922
License Number CACB 814448'
"With(feed om.comes chotces,make the«ght.one—`
Custo ner-Name:Elizabeth,BlenkOHome Phone: (228)990-0332
Street Address. 200,soiida dr Alternate Phone:
City„state,Zip: Port-Saint:Lucie F134983 Email Address: Gamliz@aol.com
Eguipment and Installation:S ecificati_ons
Need pad.0%for 60mo financing
14i4CXS036=230 16 SEER 1 : 10 YearLabor Warranty 1 <` New 314 PVCrprain
Outdoor Model Number r
1 10kw HeaYStnp 1 = New:Heavy Duty Copper ,
S�9X25UHV
042A f Lineset
Indoor Modei Nlunber i 1 New,palnted top decking.,:
1 R 11 required permitting S
CoilModel Number 1 Newapply or Retum
1 .Comp 1Plenum
y",ear Energy,
77!32818 SA rigAgrbement ,. 1 New,thermostatwireto
AHRIiCert113ed Ref Nturtber 1 F.raedorn,arentee Co��ff
'Package': 9 Rf Dlrct Drop
1 Hunicane Tte Downs' 1 Vibrailon Isolation Pads
Product Warranty 7 Meta!Line Cover 1 Water safety:switch
10YRS•jeompressor; ,
Heat Exchanger aw :s Lennox 300M
Lennox Single'
107RS• FAIIOther PartsStage
- F
•- • - •-• •• • EUG161.E CREDit£IREBATES
FPI rebate acct*1828988459 5150.00
Add for
"Add for
Aaa=- for
Add" for ProjecfTotals: Down Payment
System Investment S11-039-00 Sub Total:
All Accessories $0:00 Rate_
00600
Other Est-MonthlIyy
TotaLAmount Investment wilft
Stt'.03800 .... Approved Credit,.
Etstfmated Final Investment f
After Eligible Reliates.and'CredNs $10,888 00'•';
Terms
Price includes all tax,labor and materials.-Amount due upon recelpt.No warranty on drain lines whatsoever.Owner must maintain-filter and drain line
regularly to ensure proper,operation.Freedom-Air and•Heat,Inc is not responsible tcrdamage caused by lack of maintenance.This proposabis
30 days. :gaod for
Acioeptance.(Customer) A ptance mpa )
a.Q- 4,'�� &'J�)
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