HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i
Date: 04/04/201'9 Permit Number:
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 Residential x
PERMIT TYPE:
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Address: 647 Nettles:Blvd.Jensen Beach FL 34957
Property Tax ID#: 4502-501-0833-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Pettinga AC Changeout.
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Installation of orie 2.5 ton 14 SEER Grandaire package air conditioning system complete with 8 kw electric heater.
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Additi nal work to be performed under this permit–check all that apply:
_Mechanicall —Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ $3',800.00 Utilities: —Sewer _Septic Building Height:
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Name Bill Pettinga Name:Juan Cruzado
Addressr2540 English Oak CT Company:Jensen Beach Air& Heat LLC
City: Grand Rapids State: 'Address:2092 SE Hanford Rd
Zip Code: 49512 Fax: City: Port St Lucie State:FL
Phone No. 16-827-1724 Zip Code: 34952 Fax:
E-Mail: Phone No 772-334-3200
Fill in fee si ple Title Holder on next page(if different E-Mail jensenbeachac@gmaii.com
from the Owner listed above) State or County License CAC1818779
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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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 grantingof 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU.INTEND TO .OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OP COMMENCEMENT."
Si a e of Owner Less a/Contractor as Agent for Owner Signatur o ontractor/Licen Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sl Luie COUNTY OF Sl cede
The forgoing instrument was acknowledgefore me The forgoing instrument was acknowledgq6ffiefore me
this 41h day of April 20A by this 41h day of April 20by
Eon (_AU2flD6 ori 121 r)
Na a of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature of Niofary Public-State of Florida) ( ul•e otary lic-State of Florida)
STAt. MARIE C FF993217 ►"
Commission No. FFss32n R' ` 2a1)' t;QRS ion No. ;!"'f+�',_Se?j) STAL MARIE C i. too
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pMMISSION# F993217 =': 'E MY COMMISSION#F 3217
nnon
EXPIRES Aun-)
.•'rYl„� EXPIRES June 25 2 0
407)�9A•C :. FloridaNeterySery e.corn t �
REVIEWS FRONT ZONIN ..�..��
_. VEGETATION SE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev.2/7/19
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