HomeMy WebLinkAboutClark_ Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/23/2020
J_
s
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:AC Changeout
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential X
Address: 8750 S Ocean Drive, Unit PH 39, Jensen Beach, FL 34957
Property Tax ID #: 3535-601-0093-000-5
Site Plan Name: n/a
Project Name: n/a
DETAILED DESCRIPTION OF WORK:
Like for Like AC Changeout. Installing 3.5 Ton BOSCH Unit. Water source heat pump.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical
Electric
Total Sq. Ft of Construction:
Gas Tank _ Gas Piping
Plumbing _ Sprinklers
Cost of Construction: $ 2,700.00
_ Shutters
Generator
Sq. Ft. of First Floor: _
Lot No.
Block No.
Windows/Doors
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Richard Clark
Name: Kim Wilson
Address:8750 S Ocean Drive Unit PH 39
Company: Premier Plumbing and Air
City: Jensen Beach, FL State:
Zip Code: 34957 Fax:
Phone No.860-989-8029
Address: 108 NE Dixie Hwy
City: Stuart State: FL
Zip Code: 34957 Fax: 772-692-1094
Phone No772-692-2500
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail preplbgac@gmail.com
State or County License CAC-033574
IT value oT construction is jZ5UU 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.
DEMGNEWNG{l`iEER: Not Appfitable
Name:
Address:
City: State.
Zip: Phone
FEE SIMPLE TITLE HOLDER: , Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMP Y: _ Not Applicable
Name: fQ
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address'
City.
Zip: Phone: --
OWNER/ CONTRACTOR AFRDVIT Ap�rica lion 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)Wth any applicable Home Owners Association rules, bylaws Drana covenants that may restrict or prohibit such
structure. Please consult whth your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, l 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 oxetrtpt from undergoing a full concurr"cy review: room additions,
accessory structures, swithming psis, fence :walls, sVs, screen rooms and accessolry uses to another non-residentia l use
"WARIINNG TO OWNEW YOUR FAXAM.TO RECOM A NOTICE OF MAY RESUILT pN YOUR PAYING
T WE FOR M E1-0 TO YOUR P11110111116IRTY. A NOTXX OF NWT BE RECORDED AND
POSTED ON TIM JOB SM BWM TM FWST 111111iISPECT1101111. IF YOU W M TO OBTAN FRIANCING, CONSULT
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Signature of Owner/ Lessee/CmTbadoras.A*e0t'far Gamer signature of Contractor/License Holder
i
STATE OF FLORIDA STATE OF FLORIDA�,� —
COUNTY OF. '>TT : 14 C°- COUNTY OF
The forgoNpg instru t was acknowledgedbefore me
this�3 day of f f 2! % by
Name of person making statement.
Personally Known OR Produced identification
Type of identiflcation
Produced
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(Signatur4 of Notary of FI&ft )
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RECEIVED
DATE
The forgojng instrum t-was acknowledged before me
this day of C-1 1 . 2p DQ by
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Name of person making statement.
Personally Known �_ OR Produced Identification
Type of Identification
Produced
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