HomeMy WebLinkAboutBuilding Permit Application I
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' J' 1 Permit Number:
RECEIVED
A s
- - - - ---_-- - Building Permit ApplicatioriJUL 0 3 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE: kd A
PROPOSED IMPROVEM N L&AT ON:
Address: gn S NCCN A
Property Tax ID#: 001 - C06 � - 0-2-33 000 - Lot No.
Site Plan Name: Block No. &�
Project Name:
DETAILED DESCRIPTION OF WORK:
o Leek- ps�
CONSTRUCTION INFORMATION:
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Additional work to be performed under this permit-check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
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Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ (L700 t D0 Utilities: —Sewer —Septic I Building Height:
OWNER/LESSEE: CONTRACTOR: .�
Name �� Name: 1 �p QX_ 1 1 14:�'7A"Y.A E-nS
.Add ress: , . - A ComparrVP f\A9,1'•i=i&C_
City: State.r--L Address: 15 3L UMVVNVC�_ i4\._
Zip Code: Fax: City:-\)ZM �2GL� State:__'F_L
Phone No. Zip Code: -16,9GO I Fax:77 A_ _56
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed aboi! 'Y�� ��I'I� �' ��II�11a tate or Count I11s Anse i�i�co-5 o�J�
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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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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 OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEF9RE TME FIRST INSPECTION. IF YOU INTEND TO ,OBTAIN FINANCING, CONSULT
WITH YOURONDEJ9 OR AN. ORN BEFORE RECORDING YOUR NOTICE.OF COM ENC ENT."
Signature of Owner/Lessee/Contractor as Agent for Owner ignature of Contractor/License Holde
STATE OF FLORIDA STATE OF FLORIDA °
COUNTY OF RI 142Jo COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this3 day of 201a by this rc day of J r. 20a by
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Name of person making statement. Name of pe son making statement.
Personally Known y/ OR Produced Identification Personally Known v OR Produced Identification
Type of Identification Type of Identification
Produced Produced
��� y,� M�
�.•� Y�',, , BARBARA AN M �•
(Signature of Notary Public-State o tary Public-S Laj f Notary Public- a i jda� MURK Y
Commission 5 ;_¢`�«�� otary lic State of FI ri a
�N9T ;� My Comm.Expire g18 N I=a3 C mission#FF 2315 5
Commission No. o TP°; �lY�9�,m.Expires Aug 18,2 9
Bonded through Nati ssn. •,,FOFF,o�,
Bonded through National Notarl A n.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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DATE
COMPLETED
ev.
PROPOSAL
Lic.#RA-0044628 BARKER ELECTRIC - Serving Indian River
Lic.#CAC057252 County Since 1959
Lic.#CAC1816135 AIR CONDITIONING &HEATING, INC. Full Sheet Metal Shop _
For the Best In Service
1936 Commerce Avenue•Vero Beach,Florida 32960•(772)562-2103 •Fax(772)562-5340
825 U.S.Highway 1 •Sebastian,Florida 32958•(772)589-9899+Fax(772)589-9917
PROPOSAL SUBMITTED TO: PHONE: (,� c� C[ DATE
PHONE: I f D�® U� 2.9 R! UE \
STREET /- JOB NAME
CITY,STATEAND IP CODE JOB LOCATION
ST. Lucie CounW, Permitti
I EQUIPMENT SPECIFICATIONS
SEER: I MANUF: A Ir.rr ,�, TONAGE: L1 HEATR W.: �HEAT PUMP
A) COND.UNIT M#: er1 I I'd LI A/H M#: A/H LOCATION
B) SEER: V MANUF: �2,�. , TONAGE: L-I HEAT K.W.: !1 HEAT PUMP 1'
COND.UNIT M#: / A S b L-1I e A/H M#: i4 n 1 Li \ ii A/H LOCATION
C) SEER: MANUF: TONAGE: HEAT]K.W.: HEAT PUMP
COND.UNIT M#: A/H M#: A/H LOCATION
D SEER: MANUF: TONAGE: HEAT.K.W.: HEAT PUMP
COND.UNIT M#: A/H M#: A/H LOCATION
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NEW P...ROPERLY SIZED.FREON LIN SIZE; , NEW CONDENSATE PUMP j 110 VOLT: 230 VOLT:
NEW-INSULATED A/H PLATFORM NEW THERMOSTAT M#
NEW OUTDOOR CONCRETE SLAB SIZE: YRS,PARTS WARRANTY/ L3`YRS.LABOR WARRANTY
STRAP DOWN OUTDOOR UNIT I YRS.COMPRESSOR WARRANTY/ ��YRS.COND COIL WARRANTY
MAKE AIRTIGHT PLENUM CONNECTIONt A/C PERMIT INSPECTION INCLUDED
LINE EXISTING PLATFORM CHECK FINISHED JOB FOR QUALITY
BARKER A/C WILL NOT BE HELD RESPONSIBLE FOR ANY REPAIRS, DAMAGES,OR CRANE
EXPENSES DUE TO OR RELATED TO MOLD.UNFORTUNATELY, MOLD CAN OCCUR R 410-A FLUSH KIT
FOR MANY REASONS THAT WE CANNOT CONTROL.WE STRONGLY RECOMMEND
SERVICING YOUR A/C SYSTEM 1 OR 2TIMES AYEAR. OWNER UNDERSTANDS:
_ I BARKER A/GIS NOT RESPONSIBLEFOR EXISTING FREON LINES
PAYMENT TO BE MADE AS FOLLOWS: ( /� p� .. A) INSTALLED PRICE:
By signing below,you,the Customer,acknowledie and agree that arker Electric Air CoRdition-
ing and Heating,Inc.("Barker A/C")shall be entitled to recover any and all of its attorneys fees, B) INSTALLED PRICE:
court costs, and all other costs of collection or enforcement of the terms of this Proposal,
including but not limited to appellate attorneys fees and costs,from you,in the event fees-or C) INSTALLED PRICE:
costs are incurred as a result of your failure to pay in full and on time or in the event that Barker
A/C is required to take any action to enforce this Proposal due to your breach thereof,regardless D) INSTALLED PRICE:
of whether a law suit has been filed.Barker may charge a finance charge of 18%per annum or
the highest rate allowed by law,on any late payments.
' (Customer signature)
Acknowledged and Agreed to on this day of—L,20 lg by: (Customer printed)