HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S'h:
COUNTY
F LOR I DA
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: meqHANICAL/HVAC RESIDENTIAL REPLACEMENT SYSTEM
PROPOSED IMPROVEMENT LOCATION:
Address: 10725 SOUTH OCEAN DR LOT 98 JENSEN BEACH, FL 34957
Property Tax ID #: 4511-501-0303-000-3 Lot No.
Site Plan Name* HOl-IDAYOUTATSTLUCIEBLKKLOT6ANDEQUALPR(>fiATAINTERESTiNCOMMONELEMENTS(OR1357-131;3017-412) BloCk NO
Project Name: COE AC CHANGE-OUT
DETAILED DESCRIPTION OF WORK:
AIR CONDITIONING CHANGE OUT FOR LIKE FOR LIKE SYSTEM FOR RESIDENTIAL BUILDING.
INSTALLING 14 SEER 3 TON PACKAGE UNIT MODEL # WJA436Q0QKTP0A1 WITH 10 KW HEATER.
AHRI CERTIFICATE NUMBER: 7492886
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Mechanical Gas Tank Gas Piping Shutters
Electric Plumbing Sprinklers Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: S 3862.00 Utilities: Sewer Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:CONTRACTOR:
Name ELAINE COE Name: ROBERT P CAMPBELL JR
Address: 10725 SOUTH OCEAN DR LOT 98 Company: BUILDING TECHNOLOGY SERVICES INC
CItv: JENSEN BEACH State:Address: 1520 BUCKINGHAM AVE
Zip Code: 34957 pgx; N/A Citv: WELLINGTON state: FL
Phon6 No. 508-759-8301 Zip Code: 33414 pgy- N/A
E-Mail: N/A Phone No 561-712-1126
Ffll in fee simple Title Holder on next page (if different
from the Owner listed above]
E-Mail R0B@BTS-AC.COM
State or County License CAC058685
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.
SUPPLEMENTAIGONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:Address:
City: State:CItv: State:
Zip: Phone Zio: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:Address:
Citv:Citv:
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 appiications 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 IMPROYEMENTS 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 OF COMMENCEMENT."
lOxASU Co<
ure of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLOR,
COUNTY OF
The forgoing instrument was acknowledged before me
this davof CT\fXX \ . 20 IR by
eiQinn. Cae
Name of person making statement.
Personaliy Known
Type of identification
Produced.
. OR Produced Identification )C
(Sig^ture of Public-^ate^of Fiorida )
Commission No. 53 ENGLAND
NotaVyTublic - State of Florida
Commission - GO 333870
AUvfomm F«pirns MJy 11 7071
Signature of Contractor/License Holder
STATE OF FLORIDA ,
COUNTY OF
The forgoing instrument was acknowledge^before me
quacthis \0 day of., 20I n
ItatName of person making statement
Personally Known
Type of Identificati
Produced
OR Produced Identification
State of Fiorida(Signature
Commission No.
iiEL England
Notii^^ii/ic - State of Florida
Commission 7 GG 333870
My Comm. Expires Mav 13. 2QZ3
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