HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
11/25/2018 Permit Number: 18.11— 1
Date: ��
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COUNTY ' .
F:4 O R `t D A - RECEIVED
Building Permit Application Nov 2 6 1d16...
Planning and Development Services .
Building and Code Regulation Division permitting®®pa1refi
2300 Virginia Avenue,Fort Pierce FL 34982 St.Lucie Count,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENTLOCATION: .
Address: 8740 Champions Way, Port St Lucie, FL 34986,
Legal Description: Island Club Guard House CS O t �,t`�M
9ak -
Property Tax ID#: ' '&31-k- 5fi D- Coo)-(-)00 /7 Lot No.
Site Plan Name: .. Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out like for like replacing 1 1/2 ton ac unit with carrier, condenser 24APB618A003, and air
handler FB4CNP018L00, 16 SEER, 5 kw heat.
CONSTRUCTIOWINFORMATION: , "
Additional work to be ertormed under this permit—check all- apply:
I✓ HVAC IIGas Tank OGas Piping Shutters Q Windows/Doors
lElectric 0 Plumbing [ Sprinklers 0 Generator [liii Roof Roof pitch
Total Sq. Ft of Construction: S9..2.1 of First Floor:
Cost of Construction:$ $3800.00 Utilities: 0Septic Building Height:
OWNER/LESSEE "*` " - CONTRACTORS `!
Name Reserve Association Inc .. Name: Keith Thompson -
Address:2160 Reserve Park Trace company: AC Keith Inc.'
City: Port St Lucie; ....< :,.r.. State:FL Address:.,690 SW Pueblo.Terrace ...•-..,
Zip Code: 34986 Fax:n/a - City: Port St Lucie State:FL
Phone No.561-866-8110 Zip Code: 34953 Fax: n/a'
E-mail:dianeb@langmanagement.com Phone No. 772-519-1351
Fill in fee simple Title Holder on next page(if different E-Mail: ackeithl@att-net
from the Owner listed above) State or County License: CACI 813976
If value of construction is$2500!or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ,
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:690 SW Pueblo Terrace 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
commenci g work or reco •ing your Notice of Commencement.
, _. ....",'
ature
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Signature of Owner/Less-•'/Contractor, as Agent for Owner Sig of Contractor/Li ense Holder
STATE OF STATE OFCOUNTY OF FLORIDA Si- L )c 2 COUNTY OF FLORID
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 05 day of MOO ,20 Ig by this day of 4.1oJ ,20\" by
.. e I*k -Tv rn \ 1�e,AA., �r
Name of person makl g statement Name of person makings tement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced i-er-i S*-e '\tl'iri e.___- Produced -t=L 1J L-ieR
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re o o.- -. : • - • • '• (Signat . - i • - ., f ',la
1 'o4rpL ': STEFANIE y4�YPLa•' 1 STEFANIE JOHNS
Commission O.( __:.., •r:1 Notary Public-SIIat�f/Florda Commis •. ,�� Notary Public-State of Floridan I)
.� '''"' e` — commission p GG 248504
I :(,�of�dr; Commission#GG 2485041 ,orfs;,,,'
( • My Comm,Expires Aug 14,2022 f My Comm.Expires Aug 14,2022 I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED_
DATE
COMPLETED
Rev.8/2/17