HomeMy WebLinkAboutCOPPENS building permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02/19/2020 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: T
Haaress: D u,.rzmi-q UM cU 1 ?FsZ(D. JCNStN BEACH FL 34957
Property Tax ID #: 4511-501-0083-000-4
Site Plan Name:
Project Name:
Lot No. 38
Block No. B
DETAILED DESCRIPTION OF WORK:
A/C CHANGE OUT. SAME FOR SAME. 3 TON 14 SEER FRIGIDAIRE PACKAGE UNIT WITH 10 KW HEATER
CONSTRUCTION INFORMATION: T_
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:
Cost of Construction: $ 4000
Sq, Ft. of First Floor:
Utilities: _ Sewer _ Septic
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE: --�
CONTRACTOR:
Name James Coppens
Name: JUAN CRUZADO
i
Address: 114 DOVER MILLS RD
Company: JENSEN BEACH AIR & HEAT LLC
_ _
City: PORT DOVER, ON NOA 1N1 CANADA State:
Zip Code: Fax:__________
Phone No. 7722147158
Address: 2092 SE HANFORD RD
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No 7723343200
_
E-Mail: COPPENSJIM@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of ennctrtrrtinn is hrnn ......,, , r)rf,^nnrr�
E-Mail JENSENBEACHAC@GMAIL.COM
State or County License CAC1818779
- - ----- -1 - ...,...,... w, . 111ncn6C.111crlt ID requirea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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POP'
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 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:"
Si a e of Ownee/Contractor as Agent for Owner
Si re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF iST-,
STATE OF FLORIDA
COUNTY —. I
OF An F
The o oing instrume t s a k o ledg d before me
this day of 20 by
The ins r nt was ack owledged j�efore me
ling
thisday of 20 l.Vby
dIlAkI. l ,1 L(A�
V
Name of person making tatement.
_
Name of person ma ng statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
_
Type of Identification
Produced —
"MAI
Produced
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(Signature of Not ry/i ub Ic- tattle of Florida)
Si na ure
of Notar P blic- State of Florida )
R�`UZADO
Commission No q J� _ >jw`�ri` �I) CRYSTAL MARIE
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MARIE C�MY
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June
5, 2020
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VEGETATION
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REVIEW
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DATE
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DATE
COMPLETED
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ADO
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