HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/07/2019 Permit Number: QXO
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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
PERMITTYPE:A/C Change Out
RROPL7SD 1NPR0lEMENT LOCATiQN $3
Address: 276 Nettles Blvd Jensen Beach, FL 34957
Property tax ID#: 4502-501-0462-000-7 Lot No.
Site Plan Name: NETTLES ISLAND INC,A CONDO-SECTION II PARCEL 276 Block No.
Project Name:
pETAILED DESCRIPTION (?F WORK °
A/C Change Out Like For Like
3 Ton 14 SEER Package Unit with 8 KW heat strip
CONS �t0CT11UN INI'ORM�TION r
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Additional work to be performed under this permit–check all that apply:
_Mechanical `Gas Tank —Gas Piping _Shutters —Windows/Doors
—Electric —Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 4382 Utilities: —Sewer _Septic Building Height:
QWNER/LESSEE, K I CONTRACTOR4 tr
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Name Tom.Byrnes Name:Ramon Lalloo
Address:276.Nettles Blvd Company:Frigid Air LLC
City: Jensen Beach State:_ Address:1651 SE Goucho Ave
Zip Cade: 34957 Fax:' City: Port Saint Lucie State:FL
Phone No.347-419-5594 Zip Code: 34952 Fax:
E-Mail:ROBBIEHARRIS1@VERIZON.NET Phone No 772-212-1113
Fill in fee simple Title Holder on next page(if different E-Mail acinfo@frigidair.cool
from the Owner listed above) State or County License CAC1819319
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:
I Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
k Name: Name:
Address: Address:
I 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 1 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 jobsite
before the firs on--I intend to obtain financing, consul r attorney before
commencwork <r" cording r Notice of Commencement—,-,
lgnature of O ner/ see/Contractor as Agent for Owner Signature o fContracto icense Holder
STATE OF TATE F R?,1�DDA
COUNTY OFFLORIDA+
7Y OF \C_\C
The forgoing instrument was acknowledge efore me The f oing inst ment was acknowledged before me
this day of S=Y 2( by this 7 day of k �"� 2006
'Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
/41P m 0 V Ly I�, J
(S nature of Notary Public-State of Florida) Ig ature of N
t� RACHAEL LIt�TON
Commission' o. ,�i�,, Rnr unEL CLIP bN Commission No =s _t�atary Public-St ommission #GG 318424
a�
,-Notary Public-State of'Florida ,y a
=+ *� .Commission#GG.318424 oan��a` My Commission Expires
QWdkd` lvty mmission 23pires It
REVIEWS RV1.S0R PLANS VEGETATION S A OVE
OUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
U117
DATE
RECEIVED
DATE
COMPLETED
Rev.9/26/18