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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/19/18 Permit Number:
s
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 IMPROVEMENT LOCATION:
Address: 7420 S Ocean Drive Unit 716
Legal Description: Sanddollar Villas Condominium C -Unit 716 and Und pro -rata sharein common elements
Property Tax ID #: 3522-604-0041-000-5
Site Plan Name:
Lot No._
Block No.
Project Name:
Setbacks Front _ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Like for Like AC Change out split system on roof 2.5 ton 16 seer 8kw
CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit — check a that appy:
HVAC 11 Gas Tank F]Gas Piping ❑_ Shutters ❑ Windows/Doors
Electric ❑ Plumbing ❑ Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 1113
Cost of Construction: $ 2500.00_
SFt. of First Floor: _
Utilities:cnSewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DOUGLAS MANLEY
Name: KIM WILSON
Address: 7420 S OCEAN DR UNIT 716
Company: PREMIER PLUMBING & AIR LLC
City: JENSEN BEACH _ _ State: FL
Zip Code: 34957 Fax: _
Phone No. 845-641-9435
Address: 108 NE DIXIE HWY
City: STUART State: FL
Zip Code: 34994 — Fax: 772-692-1094
Phone No. 772-692-2500
— ---
E -Mail:_
_ _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: PREPLBGAC@GMAIL_COM
State or County License: 25222
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: 108 NE DIXIE HWY
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 your Notice of Commencement.
Rev. 8/2/17
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF _
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this __ day of _ 20 by
this day of 20__ by
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. _ (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17