HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02/25/20
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: HVAC
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential x
Address: 10701 S OCEAN DR #658 JENSEN BEACH, FL 34957
Property Tax ID #: 4511-805-0059-000-0
Site Plan Name:
Project Name: YURASEK AC CHANGE OUT
DETAILED DESCRIPTION OF WORK:
Lot No.59
Block No.
LIKE FOR LIKE 3TON 14 SEER GRANDAIRE PACKAGE UNIT AC CHANGE OUT WITH NO DUCT WORK. AHRI #. 202717857
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
XMechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 5599.80
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name GERRY YURASEK
Name: ROBERT CAMPBELL
Address:10701 S OCEAN BLVD #658
Company: BUILDING TECHNOLOGY SERVICES INC
City: JENSEN BEACH State:/�
Zip Code: 34957 Fax: N/A
Phone No.772-229-3257
Address: 5670 SE GROUPER AVE
City: STUART State: FL
Zip Code: 34997 Fax: N/A
Phone No772-600-7151
E-Mail: al9analyst@aol.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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: A' Not Applicable
Name •
BONDING COMPANY: V Not Applicable
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."
Signature of Owner/ LesseeKontractor as Agent for Owner
Signature of Contractor icense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MARTIN
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 25 day of FEBRUARY 20_ by
this 25 day of FEBRUARY . ZO_ by
ROBERT GAMPELL
ROBERT GAMPBELL
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
(Signatur Notar IIc-Sta o�i 3rda) DANIELENGLAND
T
(Si nature of otary lic-St P?.. Ida) JANIE- ;
Notary Public - State of Fl
Commission No. GG333870 '+.tom ' �'e OCommission -GG 3336
Ay Comm.
riaa `�' NJ �:%:a:y °uJr State of Plon
r[ mission NO. GG333870 `: P /ISC6 issior _
' GG 337870
.. Ex,ires May 13.
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19