HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/24/2019 Permit Number:
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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: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 9550 S. Ocean Drive, Jensen Beach, FL 34957 Unit 710
Property Tax ID #: 4502-601-0064-000-4
Lot No.
Site Plan Name: Block No.
Project Name: _
DETAILED DESCRIPTION OF WORK: 1
Like for Like AC Change out- 3.5 ton BOSCH watersource heat pump -eer 13.6, KW 40.
j CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
heMechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof _ Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2,500.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Linda Kohler
Name: Kim Wilson
Address: 9550 S Ocean Drive -Unit 710
Company: Premier Plumbing and Air
City: Jensen Beach, FL State:
Zip Code: 34957 Fax:
Phone No. 732-614-2989
Address: 108 NE Dixie Highway
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 CAC-033574
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 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 JOB SITE BEFORE THE FIRST EWSPECTION. EF YOU WTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FL
COUNTY OFORIDA �+
COUNTY OFSTATE OF ORtDA ��C,lc
I The forgoing instrument was acknowledged before me
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The forgoing instru evt was acknowledged before me
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this,, , day of 20 by
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Name of person making statement.
Name of person making statement.
y Kn�o �n OR Produced Identification
Personally Known' OR Produced Identification _
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(Signatur of Notary P ic- State of Flo da }
(Signature Notary Public- State of Florid
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