HomeMy WebLinkAboutBuilding Permit Application ' I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/20/2020 Permit Number:
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Building Permit Application oaot. Ndr
Planning and Development Services a@Ala:)3*d
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 9628 Enclave Circle, Port St Lucie, FL 34986
Legal Description: Enclave at the Reserve
Property Tax ID#: 3322-800-0011-000/4 Lot No.8
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:. Left Side:
DETAILED-DESCRIPTION OF WORK:
Change out like for like 4 ton,2 speed , 16 SEER,8KW heat, Carrier condenser 24ACB748A003, air
handler FV4CNF005L00
CONSTRUCTION INFORMATION. .
Additional work toe e orme under this permit—c ec a appy:
HVAC E]Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing OSprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ $7350.00 Utilities: Sewer❑Septic Building Height:
OWNER/LESSEE: „` CONTRACTOR:
Name Ann and Doug Goschke Name: Keith Thompson
Address:9628 Enclave Circle Company: AC Keith Inc.'
City: Port St LucieState:FL Address:
Zip Code: 34986 Fax:n/a City: Port St Lucie State: FL
Phone No.772-201-7364 Zip Code: 34953 Fax: n/a
E-Mail:ann@dragonflyprop.com Phone No. 772-519-1351
Fill in fee simple Title Holder on next page(if different E-Mail: ackeifh1@att.net
from the Owner listed above) State or County License: CAC1813976
i
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
.SUPPLEMENTAL.CONSTRUCTION LIEN LAW WORMATION:
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 andinstallation 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
commencing work r cordin our Notice of Commencement.
Signature of Owner/ see/Contractor as Agent for Owner Signature of Contractor/License er
STATE OF FLORIDA1 - - STATE OF FLORIDA
COUNTY OF S i Lwut' COUNTY OF ZT �.LlGL2
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this al�l—day.of �Ct f1 moi, 2020 by this day of ZrO,4,' 20V-0, by
Name of person making statement Name of person making st tement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identifica ioi),.
Produced L Produced
(Signature of Nota u - (Signature of No Public-State of Florida)
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'�% :° a Commission No. .o„11��/�B�'•. SAVITqQ�4
Commission No. _ Notary Put - ate of Floilda
Commission#FF 966265 ' * * _ Notary Public M 'QCommission Y Comm.Expires Apr 1,2020 ,;.F °P`Oc' WY-1.ZVZU
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIO S AVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17