HomeMy WebLinkAboutBuildi9ng Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/3/2019 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Fierce FL 34982 X
Phone: (772) 462-1553 Fax: (772) 462-1.578 Commercial Residential
PERMIT TYPE: MECHANICAL CHANGE OUT
PROPOSED IMPROVEMENT LOCATION 8160 BUCKTHRON GIRCLE
AAA CC- 8160 BUCKTHRON CIRCLE
Property Tax ID #: 3425-701-0124-000-1
Site Plan Name:
Project Name: ROUDEBUSH
DETAILED DESCRIPTION OF WORK:
A/C CHANGE OUT LIKE FOR LIKE. GOODMAN - 2.5 TONNAGE, 14 SEER.
Lot No. 11
Block No, 5
CONSTRUCTION INFORMATION: I
Ad itional work to be performed under this permit— check all that apply:
echanical — Gas Tank _ Gas Piping Shutters Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total 5q. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5826.00 Utilities: _ Sewer _ Septic Building Height:
OWN EIS/LESSEE:
CONTRACTOR..
Name MARIE ROUDEBUSH
Name: SHERRIED WATSON
Address: 8160 BUCKTHRON CIRCLE
Company, PROMAG ENERGY GROUP A/C & HEATING
City: PORT ST_ LUCIE State:
Zip Code: 34952 Fax: NIA
Phone No. NIA
Address: 3300 37TH STREET
City: ORLANDO State: EL
zip Code: 32839 Fax: NIA
Phone No 4073805560
E-Mail: NIA
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail PERMITS@p PROMAGENERGYGROUP.COM
State or County License CMCA48033
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION EiEN 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:
Zip: Phone:
City:
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.
5t. 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 JOB SITE BEFORE THE FIRST INSPECTION_ IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y R LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Contractor/License Holder
i nature k Owne / Lessee/Contractor as Agent for Owner
STATE OF FLO
STATE OF FLORIDA
COUNTYOF_FL
F
COUNTY OCr
The forgoing instrument was acknowled ed before me
3 day DECEMBER
The forgoing instrument was acknowled ed before me
3 DECEMEBER
this of , Z�� by
this day of , 200 by
Name of person making statement.
Name of person making statement.
P sonally Kn n OR Produced identification
Personally Known OR Produced Identification
ype of Identific tion
Tyg_ Identification
Produced
roduce
ignature of Notary Public- State of Florida }
Signature of Notary Public- State of Florida j
Commission N
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Commission No.
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