HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/01/18 Permit Numbe •
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 IMI?RO tMENT LOCATION
Address: 9600 S Ocean Drive Unit 205
Legal Description: Empress Condominium Unit 205
Property Tax ID#: 4502-620-0009-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPT..ION OF WORK #
x = w
Like for Like AC Change out 2:5 ton 16 seer 7.5kw split system
CC3NSTRUCTON INFO
IRMATION
s`
Additional work tone nerformecl under tispermit—c ec all appy:
HVAC 0 Gas Tank []Gas Piping _Shutters Q Windows/Doors
1-1 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2500.00 Utilities: Sewer O Septic Building Height:
OWNER%LESSEE CONTRACTOR '
NameChades Shelton Name: Kim Wilson
Address:9600 S Ocean Drive Unit 205 Company: Premier Plumbing and Air LLC
City: Jensen Beach State:FL Address: 108 NE Dixie Hwy
Zip Code: 34957 Fax: City: Stuart State:FL
Phone No.' Zip Code: 34994 Fax: 772-692-1094
E-Mail: Phone No. 772-692-2500
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.
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DESIGNER/ENGINEER': NotApplicabie MORTGAGE COMPANY: n Not Applicable
Name: Name:
Address: Address:
city:: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: - - _ City:
Zip: Phope• Zip: Phone:
[certify work orinstaliation has commenced prior to the issuance of a permit.
St.Lucie Counttyy 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 orandcovenants th•at may restrict or prohibitsuch
structure:'Please consult your Home.Owners Association and review your deed forany restrictions which may apply:
In consideration of the;granting:of this requested permit,i do hereby agree that, will;.in,all respects,.perform the work
in accordaiice`with the.approved plans,the Florida Building Codes a.nd,St.Lucie County Amendments.
The following building permit applications are exempt from undergoing:a full concurrency review:room additions,
accessory structures;swimming,pools,fences,,wills,signs,,screen rooms and accessory uses to another non-residential use
WARNING TO'OWNER:Yourfallureao Record&Notice of Commencement_may result hi your paying twice for
.improvernents-to yourproperty.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
commencin -work.or recording our Notice-of Commencement.
_5ignature.of Owner/Lessee/Agent Signature of Contractor License Holder
STATE OF FLORID STATEOF FLORID
COUNTY OF COUNTY OF
The f going-instru ent w s ac owledge fore me The fo going'inst ent.was c nowledg efore me
this day of 20 y this_L day of 20 by
(Name of person.acknowledging) (Name of person acknowledging)
(Signature:o.Notary Publlcvo State of Florida) (Signature of Notary Public-State of Florida)
Persn r �Q �9 --- cation Personall 1 t0 �: CIRYIIIDiR &DAuQ dEVEM ion
Type of l t caCt4��ll6iF §g Type of I grlti Y+ It AIGg41iSSt*1l 04
EXPIRES July 31,201 EXPIRES.July 31,2019
Comiigj;. Seal. Commissq "
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS