HomeMy WebLinkAboutBarger ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulotion Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 3709 WESTCHESTER CT
Commercial Residential x
Legal Description: SAVANNA CLUB PLAT PHASE THREE BLIC 41 LOT 80 (OR 3162-1947)
Property Tax ID #: 3425-705-0081-000-9
Site Plan Name:
Lot No..
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and install a 3 ton 14 SEER Allied HVAC P0? 0 Q C "q 6�— ict oc[
A tj ? P
CONSTRUCTION INFORMATION:
itiona wor to e e Orme un ert ispermit--c ec a appy:
W,MVAC`` Gas Tank F]Gas Piping In Shutters F]Windows/Doors
11 Electric LJ Plumbing Sprinklers E Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: _ �S bo Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jerry M Barger
Address: 3709 WESTCHESTER CT
City: PORT ST LUCIE State: FL
Zip Code. 34952 Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: ROBERT DUMONT
Company: AIR SOURCE 1
Address: 585 NW MERCANTILE PL #103
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax: 7728074750
Phone No. 7726267604
E -Mail: AIRSOURCEILLC@GMAIL.COM
State or County License: ST LUCIE
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulotion Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 3709 WESTCHESTER CT
Commercial Residential x
Legal Description: SAVANNA CLUB PLAT PHASE THREE BLIC 41 LOT 80 (OR 3162-1947)
Property Tax ID #: 3425-705-0081-000-9
Site Plan Name:
Lot No..
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and install a 3 ton 14 SEER Allied HVAC P0? 0 Q C "q 6�— ict oc[
A tj ? P
CONSTRUCTION INFORMATION:
itiona wor to e e Orme un ert ispermit--c ec a appy:
W,MVAC`` Gas Tank F]Gas Piping In Shutters F]Windows/Doors
11 Electric LJ Plumbing Sprinklers E Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: _ �S bo Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jerry M Barger
Address: 3709 WESTCHESTER CT
City: PORT ST LUCIE State: FL
Zip Code. 34952 Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: ROBERT DUMONT
Company: AIR SOURCE 1
Address: 585 NW MERCANTILE PL #103
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax: 7728074750
Phone No. 7726267604
E -Mail: AIRSOURCEILLC@GMAIL.COM
State or County License: ST LUCIE
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:.
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: 585 NW MERCANTILE PL #103
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. - >`
Sig ature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Halder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 2' A i^-:Q,_c« g COUNTY OF S -J 1_ .U_,CLS
The forgoing instrument was acknowledged before me
this _A,�e day of 20 lK by
Name of person making statement
Personally Known OR Produced Identification
Type of Id titificatign
The forgoing instr ment was acknowledgedPefore me
this I aday of �iJ tf P t�rt- ( , 20A by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced VA -)t_ IN C,
(Signature of Notary P ft, -State oUkK )LEN IWANKO (Signature of Notary Public- St4te o„, , qrl a
'i G'+
tary Pu is - State of Florida
Commission No. Commis�� GG 0138'29 Commission No.
My Comm. Expires Jul 20, 2020 =t oPs
"OF
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
CARRIE-ELLEN IWAI
&I)ry Public - State of
Commission # GG 01
My Comm. Expires Jul 2
MANGROVE
REVIEW