HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/22/2019 Permit Number: l ✓
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BuildingPermit Application
Planning and Development Services St.
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:,,
Address: 9200 One Putt Place Club House
Legal Description: Island Club House
i
Property Tax ID#: 3334-501-0005-000/8 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF.WORK:
Change out like for like replacing Lennox 2 speed, 3 ton ac unit with carrier 2 speed 3 ton AC,
condenser 24ACB736A003, and air handler FV4CNF005L00, 16 SEER, 5 kw heat.•
CONSTRUCTION-IN FORMATION:
Additional work to be nertormed under this permit–check all tha appy:
✓❑—HVAC Gas Tank ]Gas Piping _Shutters Q Windows/Doors .
Electric 0 Plumbing Sprinklers 0 Generator Roof Roof pitch
`�`oat' q Ft''8fitir1stiaction': _ S Ft.of First Floor:
Cost of Const ructign $ ; 5200a0b Utilities: 'Sewer�❑Se{5fic' Buijdin Height:
°' 9;', ,� y .a a r:n•t t Ir„ r - - - -
�G] OWNER/LESSEE � C�ONTRACTOR:`�'
P A Villa aO `liic:"` "�' Keith Thompson
Name 9 Name: P
Address:2140 Reserve Park Trace Company: AC Keith Inc.
City: Port St Lucie State:FL Address:
Zip Code: 34986 Fax:n/a City: Port St Lucie State:FL
Phone No.561-866-8110 Zip Code: 34953 Fax: n/a
E-Mail:dianeb@langmanagement.com Phone No. 772-519-1351
Fill in fee simple Title Holder on next page(if different E-Mail: ackeithl@aft.net
from the Owner listed above) State or County License: CAC1813976
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenci work or recoAing your Notice of Commenceme .
Cv�
Signature of Owner/Lesse Contractor as Agenns
t for Owner, .Signature of Contractor/L cee der
STATE OF FLO IDA STATE OF FLORIDA
COUNTY OF 'Z' W L,( E COUNTY OF KT Lo Q
The forgoing instrument was acknowledged before me The forgoing instrun)ent was acknowledged before me
this
/22 day of Qy S"(' 20__J_ by this 2-2-day of 20,1q by
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Name of person:making statement Name of person making statement
Personally Known OR Produced Identification X Personally Known OR Produced Identification
Type of Identificatio Type of Identifica jon
Produced Produced C, Li LL
THEODORE SARANTOS ���,. �����
V THEODORE SARANTO.
. Notary Puhlic-State of Florida s�� "�.. Notary Public- State of. a
am• Commission#GG 044773 r., .F 7
��axpiresov3200. *,,(S. nature Nota e $ (Signature of ota ryPublic-Sa
Comm:Expires Nov
Commission No. `(Seal) "''Commission No. Seal
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
_ DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17