HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f(�
Date: Permit Number: , �(��(�lJ lJ1�> v�
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:
PAOPOSEDIMP ROVE MENT:LO:CATION N
Address: 6704 Fort Walton Ave
,Property Tax ID#: 1301-612-0059-000-4 Lot No.
;Site Plan Name: Lakewood Park Unit 10 Map13/01S Block No. 121
Project Name: Bearman
.bETAILED DESCRIPTION OF WORK
After The Fact Air Conditioning Change Out
a .S s ys4 e v,, - 0' ®v vV.C&,y .
i CONSTRUCTION INFORMATION;
Additional work to be performed under this permit—check all that apply:
—Mechanical —Gas Tank —Gas Piping —Shutters —Windows/Doors
Electric Plumbing —Sprinklers Generator Roof Pitch
i Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction:$ S2 0 Ty c Utilities: —Sewer —Septic Building Height:
OV1/NER%LESSEE CONTRACTOR:
Name Donn&Angela Bearman Name:Thomas A Richmond
Address:614 SW Lake Charles Circle Company:Treasure Coast Air Conditioning&Refrigeration LLC
City: Port St Lucie State:— Address:2006 32 Ave Ste B
Zip Code: 34986 Fax: City: Vero Beach State:FI
Phone No.772 337-3135 Zip Code: 32960 Fax:
E-Mail: Phone No 772-207-3779
Fill in fee;simple Title Holder on next page(if different E-Mail tcacservice@gmail.com
from the Owner listed above) State or County License CACO23475
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.
SU,PPLEMENTAL.CONSTRUCTION LIEN;LAW INFORMATION
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:
I
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."
i
Signature of Owner/Ldssee/Contractor'as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA � STATE OF FLORIDA
COUNTY OF J� ,t P , COUNTY OF
The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me
this day of 20_ by this day of )X*rA ,20Z9 by
1 ' ���� �C�nc�M�lam_ ��l��1� lL►�h WiOha�
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced FL ;?L
( ig atu'e of Notary Public- to of Florida) (Signature
RODRIGO C.FERREIRA
Commission No. f��'•• U�SHA GRAM RAFtMING Commissions pGm Notary Public,State
z Commission#-GG 930203
MY COMMISSION#GG 275060
_ Iiv mrwm.9xaites Nov.7 2023
j'For Q` ru N Public Undervmters
REVIEWS FR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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