HomeMy WebLinkAboutLarry_Thomas_AC Permit ApplicationpdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/24/2019 Permit Number:
s
_...,.._ .. __.__.._. __. 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:Other
PROPOSED IMPROVEMENT LOCATION:
Address: 8750 S Ocean Drive Unit 636, Jensen Beach, FL 34957
Property Tax ID #: 3535-601-0030-000-6 Lot No.
Site Plan Name: n/a Block No.
Project Name: n/a
LDETAILED DESCRIPTION OF WORK:
Like for Like AC Change out. Installing BOSCH 3.5 Ton unit with a water source heat pump. No KW, 14.7 EER.
CONSTRUCTION INFORMATION:
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: n/a Sq. Ft. of First Floor: n/a
Cost of Construction: $ 2,400.00 Utilities: _ Sewer _Septic Building Height: n/a
OWNER/LESSEE:
CONTRACTOR:
Name Thomas Richard Larry
Name: Kim Wilson
Address: 8750 S Ocean Drive Unit 636
Company: Premier Pluming and Air
City: Jensen Beach, FL State: _
Zip Code: 34957 Fax:
Phone No. 772-229-5243
Address: 108 NE Dixie Hwy
City: Stuart State: FL
Zip Code: 34994 Fax: 772-692-1094
Phone No 772-692-2500
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail preplbgac@gmail.com
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.
Name: -
Address:
City: IState:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name: —
Address:
City: State:
Zip: Phone:
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SON 1114G COMPANY: Not Applicable
Name:
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Address.' 1
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIMgT: Application is hereby made to obtain a permit to do the work and installation as indicated.
[-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,) 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 oxempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fen , Walls, sighs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNS YOUR FAMURE TO RECOM A NOTICE OF COMAENCEIIIIIENT MAY RESULT IN YOUR PAYING
TWICE FOR NO ROYEII>ENTS TO YOUR PROPFM. A NOTICE OF CONNONCEMENT MUST BE RECORDED AND
POSTS ON THE .toe SITE BOOK THE IFMST DMWKT M W YOU 11riElltD TO OBTAIN F NANCBYG, CONSULT
`W1Tt1 YOUR: LEtWER OR AN A7TOWAEV BEFORE RECORDIMIS TOM IIIIOTICE OF COMIIIRNCEMENT."
Signature of Owner/ Lessee/Contractor as.Agent `for Owner Signature of Contractor/License Holder`
STATE OF FLORIDA JJ . STATE OF FLORIDA u�,(�„COUNTY OF L�C Yel COUNTY OF �1. c
The forgoing instrum t was acknowledged before me
this day of 20f., by
Name of person making statement.
Personally Known ' OR Produced Identification
Type of idommation
Produced
(j' AO� L�
(Signatu—rilof Notary PL115 ic- State of FI a)
Commission e. _. _-_
Caaaisliaa#6B
REVIEWS
COUNTER I REVIEW I REVIEW
DATE
RECEIVED
DATE
COMPLET
The f g Ing instrument waS acknowledged before me
this. Nday of /) (2� 2flby
Kim Wi ts�orl
Name of person making statement.
Known `: OR Produced Identification
Produced
(Signature of Notary Public- State of Hoi
Commission
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