HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
31/20181 `
Date: 12/ Permit Number: 1901
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S_'�`� , --- "'' RECEIVED
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monsompiumomp Building Permit Application JAN 0 2 ?019
Planning and Development Services Permik�in�B�
Building and Code Regulation Division gr, Cuda CQpnty.nt
2300 Virginia Avenue,Fort Pierce FL 34982 Qunty
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION„ . . ' + ,.,�` ,.
Address: 3724 St. Francis Lane
Legal Description: St James Park BLK 4N 1/2 of lot6 and all of lot 7(or 422-509)
Property Tax ID#: 2434-501-0054-000-0 Lot No.
Site Plan Name: Block No.
Project Name: -
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK .` _ A ' -
Change out like for like 2 1/2 ton , 16 SEER, 5KW heat, Carrier condenser 24APB630A003, air handler
FB4CNP030L00
CONSTRUCTION INFORMATION Y. .. t. {"
Additional work to be ertormed under this permit—check all- apply:
EIHVAC Gas Tank Gas Piping _Shutters Windows Doors
❑ P g (❑�Windows/
Ell Doors
0 Plumbing Sprinklers 0 Generator I_I Roof Roof pitch
Total Sq. Ft of Construction:,_ _ S . Ft.of First Floor:
Cost of Construction:$ $3750.00 Utilities:Sewer IIISeptic Building Height:
DINNER/LESSEE M": CONTRACTOR: -0 :7
Name Jeffrey and Debra Labigang Name: Keith Thompson
Address:3724 ST Francis Lane Company: AC Keith Inc.
City: FT Pierce State:FL Address: 690 SW Pueblo Terrace
Zip Code: 34982 Fax:n/a City: Port St Lucie State:FL
Phone No.772-618-3067 Zip Code: 34953 Fax: n/a
E-Mail:n/a Phone No. 772-519-1351
Fill in fee simple Title Holder on next page(if different E-Mail: ackeith1@att.net
from the Owner listed above) State or County License: CAC1813976
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
pp MORTGAGE COMPANY::
DESIGNER/ENGINEER: _Not ApplicableNot 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
comm nci g work or recording your Notice of Commencement.
C__ftri` t (----
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S gnature of Owner/Lessee/Co Actor as Agent for Owner Sig ature of Contractor/L'cense der
STATE OF FLORID STATE OF FLORIDA
COUNTY OF t D• COUNTY OF of,
The forgoing instr ent was acknowledged before me The forgoing instri ment was acknowledged before me
this'/qday of art a.-7 ,20/F by thiO/5Fday of ,p,P +-b.04.. ,20j. by
/ja"i ! 'Thon/ //),,,,z-A‘
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Name of person maki g statement Name of person making stat ment
Personally Known OR Produced Identification 1/ . Personally Known OR Produced Identification V
Type of Identification Type of Identification,, •
Produ ed FL b)L-- Produ -• l'/- i-- _
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/' I /i..-4111, /4 i
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ry( ture • No a
• b4c=State.oiFinrida 1 ® (Signat,re of No ary P bei - .- " ) •
,.,<;;;......... ' :•;,i>s"'�s;•;, CARLA J.COULTER i
o � � J.COULTER Commis ion .0. '_' \'' Not sial State of Florida (I
COmmilion Na. _, -'�y;
• Not ry u c-State of Florida ��
r Commission 4 GG 142441 ';•.. .` e Commission;GG 142441
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:9 Pe+ %9j�tS p: � My Comm.Expires Oct 30,2021
'FcoFs.' My Comm.Expires Oct 30,2021 ,,,,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED _
Rev.8/2/17