HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. July 26, 2018 Permit Number:
• RECEIVED
-- - Building Permit Applicatio JUL 2 7 2018
Planning and Development Services
Building and Code Regulation Division ST. Ducie County, Permittitlg
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
El
PROPOSED.IMPROVEMENT-LOCATION: -
Address: 102 Las Olas Dr.Jensen Beach FL 34957
Legal Description: Beach club colony-Section one NWLY 54.65 FT of lot 5(or 1148-1896)
Property Tax ID#: 4511-500-0010-000-9 Lot No.
Site Pla �� e:
Project3.illiam Stuck AC Change out(unit 2) Block No.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK;
AC Change Outs.S ton Goodman splitytem, Condenser GSX160301 F, Air Handler ASPT39C14A
kw heat 5, 14 seer (unit 2) Q2
.CONSTRUCTION INFORMATION:
itiona workto e e orme under, this permit—c ec� a appy:
HVAC EGas Tank ❑Gas Piping _Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ % 540CS O O Utilities:[]Sewer Septic Building Height:
OWNERAESSEE:t "CONTRACTOR:
Name William V Stuck Name: Stephan S Buckley
Address:6694 SW Busch St. Company: AC All Stars, LLC
City: Palm City State:FL Address: 21621 Magdalena Ter
Zip Code: 34990 Fax: City: Boca Raton State:FL
Phone No.772-240-6796 Zip Code: 33433 Fax: 561-367-3444
E-Mail: Phone No. 561-702-1943
Fill in fee simple Title Holder on next page(if different E-Mail: sfaa4995@aol.com
from the Owner listed above) State or County License: CAC 1817509
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required. a 9 a
max...
SUPPLEMENTAL CONSTRUCTION LIEN LAW WF0R11%IATION t
u
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 recording our Notice of Commencement.
Sign a of-Owner7 L se Contractor as Agent for Owner Signature of Contractor/Li nse
STATE OF FL`Q.RI STATE OF FLORIDA
COUNTY OF ck7-, Ige4 GL COUNTY OF Palm Beach
The forgoing instru ent as acknowledged before me The forgoing instrument was acknowledged before me
this qday of I 20 by this 26 day of July .20 I8 by
t l `► '�(� ! Stephan S Buckley
Na ofpers making statement Name of person making statement
Personally n YII; 4 OR Produced Identification Personally Known x OR Produced Identification x
Type of Id d. t" Type of Identification
Produce = '�Ry Produced 8240797590420
FXaR�i si NNO p
( gna u 0 o Pub Ic e o ala JSigna re ary Public-State of I
�t o`'"y- MARY JANE L INCAPRERO
Commission No.G 0 G I) Commission No. coos sb$" Y COMMIA"44 GG068568
06'- , EXPIRES April 17,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17