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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/25/2019 Permit Number: t ( lJ'- `(it(1
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COUNTY RECEIVED
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Building Permit Application MAR 0 4 2018
Planning and Development Services Pvnlltting.Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 512 Banana Lane, Ft. Pierce, FL 34982
Legal Description: Palm Grove S/D BLK J LOT 36
Property Tax ID#: 3410-503-0288-000-4 Lot No.36
Site Plan Name: Block No. J
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out like for like 3 1/2 ton , 16 SEER, 8KW heat, Carrier condenser 24APB642A003, air handler
FB4CNP042L00
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
HVAC _Gas Tank Gas Piping —Shutters I l Windows/Doors
ElElectric ❑ Plumbing ,Sprinklers �Generator El Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ $4200.00 Utilities:.j Sewer LI1Septic Building Height:
1,-- ,.OWN ER/LESSEE` " :CONTRACTOR: °" ..
H.. �.,�.��� ,gym.� _ •
Name Frank and Suzette Garra\ Name'. Keith Thompson ," ,
Address: Banana Lurie t� Com any AC Keith Inc:-'. ,
CityFT Pierce ... 7 Zs,:.;',
:' t State:FL Address }a _`""` "=
Zip Code: 34982 Fax:n/a City: Port St Lucie State:FL
Phone No.201-388-5887 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.
1
'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: 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- .cf work or recordi : your Notice of Commencement. /
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ignature of Owner/L- see/C. tractor as Agent for Owner Signature of Contractor/Lice .- Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF - L.() CJk C-__'- COUNTY OF 31 Lv G(
The fo„rgping instrpn'ient was acknowledged before me The forgoing instrument was acknowledged before me
this 2--1,�day of I�A_br &c—'1 ,20 (9 by this?)f day of -F<brc.{cy/ ,2017 by
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l"�`�I�`"\o c)N16,e,,,I--6 I _to144pso`./
Name of person making statement Name of person making statement
Personally Known OR Produced Identification `F Personally Known OR Produced Identification `,e-
Type
Type of Identification Type of Identificatio
Produced F- L
P " Produced - L- D (----
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....iiiiirt.4.4100(01101. ,-- 6 . ..
(Signature of "P: ��blt,I gt$of FlorktiAORE SARANTOS (Signature of Notary Public- - . F . •
�?rk ° Notar Public-State of FloridaCommission No. \(\ sCoik►n#GG 044773 Commission No ��13 �� 04'�rP`e( I_(TYna� EF DOBE SARANTOS
ror. E. —, Public-State of Flop[a
• '••;•F dr: My Comm.Expires Nov 3.2020 .,� Y
.,,,off ��,. 1 N IIS QTS Commission# GG 04477;
,o�Lps My Comm. Expires Nov 3, 2C 0
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17