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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: Address: 3480 ROSELAWN BLVD Property Tax ID #: 2428-702-0008-000-1 Site Plan Name: Wallace FrankDawna Hurd Project Name: Wallace FrankDawna Hurd Permit Number: Building Permit Application Commercial Residential xxx A/C Change Trane 2.5Ton 16.5Seer 8KW 4TTR603OJ10000A/TEM6AOB3OH21SA Lot No. 8 Block No. 1 Additional work to be performed under this permit — check all that apply: X rMechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ £ I �`MT Name Wallace FrankDawna Hurd Address:3480 ROSELAWN BLVD Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: City: Fort Pierce State: �c Zip Code: 34982 Fax: Phone No. 772-467-9104 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Jeffrey Lindstom Company: Lindstrom Air Conditioning Address: 3581 W McNabRd City: Pompano Beach Zip Code: 33069 Fax: _ Phone No 772-600-4088 E-Mail dulcem@lindstromair.com State or County License CAC056971 IT value or construction is !�Zsuu 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. State: FI 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 O COMMENCEMENT MUST BE RECORDED AND POSTED N HE JOB SITE BEFORE THE FIRST INSPECTION. 117 Y U INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR L NDER�R AN ATTORNEY BEFORE RECORDING 1OUR OTIC OF COMMENCEMENT." 1/60 141 Sign ature# ,O er/ Lessee/Contractor as Agent for Owner Signa�y�r 'f Contractor/License Holder STATE OF LORIDA STATF FLORIDA COUNTY OF COUNTY OF The forgoing instrume t was acknowledged before me The forgoing instrument was acknowledged before me this �:.-day of , 20� by this 5� day of _ h�,�r,,,,�� 20� by Name of person ma ing statement. Name of person maki g statement. Y Personally Known OR Produced Ide6a&qAo Personally Known OR Produced Identification Type of cd'entification 1PKYPUQ< °� mission#GG103391 Type of Identification DULCEMARTINEZ Produ Com plresMay10,2021 }�. ©A'ihtuBudget Not� Produce z Commission#GG103391