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HomeMy WebLinkAbout7624 PINE LAKES BLVDAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1111412Q19 Permit Number: lit " lmi, Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Building Permit Application Commercial Residential X PERMITTYPE:AIR CONDITIONING EXACT CHANGE OUT PROPOSED IMPROVEMENT LOCATION: Address: 7624 PINE LAKES BLVD Property Tax ID #: 3422-596-0007-000-6 Site Plan Name: PINE SUMMIT Project Name: Lot No. Block No. I DETAILED DESCRIPTION OF WORK: 1 EXACT CHANGE OUT OF 2.5 TON A/C UNIT GOODMAN.. 14 SEER 5KW 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: _ Cost of Construction: $ 2678.50 Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: NameRORY RAMCHARAN Name:RORY RAMCHARAN Address:6810 COUNTRY PLACE RD Company:AIR PLUS OF SOUTH FLORIDA INC City: WEST PALM BEACH State: Zip Code: 33411 Fax:561-557-7468 Phone No.561-313-0490 Address:6810 COUNTRY PLACE RD City: WEST PALM BEACH State: FL Zip Code: 33411 Fax: 561-557-7468 Phone N0561-313-0490 E-Ma4l:INFO@AIRPLUSFL.COM Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail INFO@AIRPLUSI=L.COM State or County License CAC1 815149 It value of construction is 5Z599 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: BONDING COMPANY: Not Applicable Name: 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 certifythatno 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 Herne 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 BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of 0iwnb4 Lessee/Contractor as Agent for Owner Signatu e o ntractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OFPALm BEACH COUNTY OFPALM REACH The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged efore me this 14 day of NOVEMBER 20A by this 14 day of NOVEMBER 20—ff by ADEL4 RD 02-14 Name of person making statement. Name of person making statement. Personally Known X OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of identification Produced Produced ttz (Signature of Notary Public- State of Florida nature of Notary Public- t f I` r' Not�ry Public State of Florid Commission NO. FF976919 o� Gr(S@§I A isle Ali-Amrat M^ My Commission FF 97691P o,xY Fuae Notary Pul tic Stage of Flasida C mission No. FF9T6919 a n Ali Arrirai C2, c i41y Commission FF 97f911) << o II -I Lo' Expires 03130i2420 s'fiaFf�o4 Expires 03l36i'202d REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.2/7/19