HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED.
Date7�' ' �1� Permit Number:
RECEIVED
Building Permit Applic tion �� ® � 2019
Planning and bevelopment5ervices ST. Lucie County, Permitting
Building and Code Regulation Division
.2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772.)462-1553 Fax:(772)462-x.578 Commercial Residential
PERMIT TYPE Other - C- ib A �.
Address; 8750 S Ocean Drive, Unit 1135,Jensen Beach, FL 34957
Property tax 117#: 3635-801-0059-000-5. - - - -- _ Lot No.
Site Plan Name:_ Block No.
Project Name:
Like for Like AC Changeout. Installing BOSCH 3-Ton Watersource Heat pump system.O-KW,Seer 14.3.
Additional work to be performed under this permit–check all that apply:
}(_Mechanical —Gas Tank —Gas Piping _Shutters _Windows/Doors
T Electric _Plumbing _Sprinklers —Generator Roof Pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor;
Cost of Construction:$ 2,500.00 Utilities: —Sewer _Septic- Building Height:
Name Roy Campanale Name: Kim Wilson
Address:8750 S Ocean Drive 1135 Company: Premier Plumbing and Air _
City: Jensen Beach, FL State:_ Address: 108 NF-Dixie Hwy
Zip Code: 34957 Fax: City: Stuart State: FL
Phone No.401-742-1793 Zip Code- 34994_ Fax; 772-892.1094
E-Mail: Phone No 772-692-2500
Fill in fee simple Title Holder on next page(if different E-Mail preplbgac@gmall.com
from the owner listed above) 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.
DESIGNER/ENGINEER: r_ Not Applicable MORTGAGF'COMPANY: Not Applicable
Name: (Dame:
Address• 'Address:
City: State: -- City, State'
Zip: PLip: 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 mada 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 Coun maces no represent titin that is granting a ppermit DI authorize the permit holder to build the subject structure
which is in con ict with arty pplica6 a Home Owners Association ruu es,,bylaw5 or a d Covenants that may rasEriCt or prohibit such
structure.Please consult w t. your Home Owners Association and review your dee 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 Ston-residential use
"WARNING TO OWNER.' YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR 1MpR0VB MIS•TQ TOUR PAX. A NOTICE OF COMMEINCEMEII F MUST 113E RIMRIDED ANIS
POSTED ON THE JOB SITE BEFOIIE THE FIRST WSPECHON. IF YOU 111NTEMD TO OBTAIN.HNAN1ICflMC7, CONSULT
Y41TH YOUR LIEIIIDER on Am ATTOR*EY AFORE RECORDING YOUR NOTKE OF COMMENCEMEIIIT:'
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OIF IFLORIDA STATE OF FLORIDA
COUNTY OF ( 13✓!c° COUNTY OF !
The far g lnstrumen was acknowledge before me The fo oing Instru nt was acknowledged before me
this.M of 20,] by this dayof�" ( 2(1 by
K, M u) 1c,M U)i I is
Name of person making statement Name of person making statement.
Personally K OR Produced Identification..._..� ersonally Known OR Produced Identification
yp on IVon
Produced Produced_____.
ISignatur of Notary P jc State of Flo a i (signature Notary Public-State of Florid
Commission r=r y�1r Commissions APIdI:Ni1PfIlk eal)*mmh01 #W LW�G7 y .
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Te—v—.277/19