HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/14/2019
Permit Number:
•
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: HVAC CHANGE OUT
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S OCEAN DR 927 S OCEAN DR JENSEN BEACH, FL 34957
Property Tax ID #: 4511-510-0127-000-3
Site Plan Name:
Project Name: BRYAN AC CHANGEOUT WITH NO DUCT WORK
DETAILED DESCRIPTION OF WORK:
Lot No. 927
Block No.
AC CHANGE OUT LIKE FOR LIKE 3T PACKAGE UNIT 14 SEER WITH 8 KW HEAT. MODEL #WJA436000KTPOA
WITH NO DUCT WORK.
AHRI # 7492886
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
,'('Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4554.21
Utilities: _Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ELIZABETH BRYAN
Name: ROBERT P CAMBELL
Address: 10701 S OCEAN DR LOT 927
Company: BUILDING TECHNOLOGY SERVICES, INC
City: JENSEN BEACH State: FT
Zip Code: 34957 Fax:
Phone No. 772-229-7915
Address: 5670 SE GROUPER AVE
City: STUART State: FL
Zip Code: 34997 Fax:
Phone No 772-600-7151
E -Mail: BANTRYBETTY@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail SUPPORT@BREATHEHEALTHIERAIR.COM
State or County License CAC 058685
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:
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 thepermit 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 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."
,e6":t-10 e& A6e4&P. a&
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this 14 day of NOVEMBER , 20 /9 by
DANIEL ENGLAND
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
�GZyGGQ.1�
(Signature of Notary Public- Sta a) DANIEL "
_ Notary Public • State osI
�< Commission s GG 333
Commission No. GG 333870
y ir, Comm. Expires May '
Bonded through Natioral Nota
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this 14 day of NOVEMBER , 20 /9 by
DANIEL ENGLAND
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Produced
JAssr�GZyGGP.(i
.
ture of Notary Public- St DANIEL ENGLAND
t►A G
'r°;;' bola�( Public •State of Flori
isston No. GG 333870 �•. (SCA)nission # GG 333870
? of A My Comm. Exmres May 13, 2
Bonded through hatiora: Notary A
ZONING
REVIEW I S UPERVISREVIEWOR I REVIEW PLANS I VEGETATIEVIEWON I S EVIERWTLE I M EVIEWVE