HomeMy WebLinkAboutBuilding permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
COUNTY
10 D UZ A
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 xX
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 3430 Southern Pines Blvd
Legal Description: SUNRISE HOMESITES S/D BLK 3 LOT 25 (0.24 AC)
Property Tax l D #: 2428-702-006 B-000-5
Site Plan Name:
Project Name: Hevner Residence
Setbacks Front Back:
Right Side: Left Side:
Lot No. 25
Block No. 3
DETAILED DESCRIPTION OF WORK: I
Replace a/c equipment, like for like
Rheem 3.5 ton 15 SEER with 10kw electric heat
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit —check all that apply:
11HVAC Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑ Generator ❑ Roof 0 Boot pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 390"0
S Ft. of First Floor:
Utilities:lnSewer Oseptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ronald & Beverly Hevner
Address. 3430 Southern Pines Blvd
Name: Wanda Gahn
Company: AC Buddy, Inc.
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No.
Address: 3746 Seminole Rd_
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. (772) 480-4136
E-Mail: acbuddyinc@gmail.com
E-Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
State or County License: CAC1818909
If value of construction is $2500 or more, 2 RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: xx 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:
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 our Notice of Commencement.
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Signature of Contra ctorAicerise Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St. Lucle
COUNTY OF St Lucie
The f riling instr ent was acknowledged before me
The for ng instru t was acknowledged before me
this for
�� 20 19 by
this-- day of 20A by
of
Wanda Gann
Wanda Gahn
Name of person making statement
Name of person making statement
Personally Known xx OR Produced Identification
Personally Known xx OR Produced Identification
Type of Identifica ' n
Type of Identification
Produc d NIA AProduce
N/A
{ nature of Notary Public- State f Florid i tina R. Parsons
{ nature of Notary Public- State of Florida )
Krishna R. Parsons
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1
Commission No. GG090836 0 �f����RYPUBLIC
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Commission No. 00090836 Q N YPUBLIC
0 o TA E OF FLORIDA
x y —STATE OF FLORIDA
' Comm GG090836
SINCE lV1%
Comm# GG090636
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17