HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential X
Address: 9650 S Ocean Dr#401 Jensen Beach, FL 34967
Property Tax ID #: 4602-610-0031-000-2
Site Plan Name: THE PRINCESS OF HUTCHINSON ISLAND UNIT 401
Project Name: Joe Golden
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
Residential AC Replacement - Replace 4.0 Ton Water Source Heat Pump Air-conditioning System
Cold Flow -Dual Air CFX049VLFATS
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
r�/(lilechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: S 6=082.00
Sq. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Joe Golden
Address: 9660 S Ocean Dr #401
Name: Adam Emanuel
Company-Arnold's Air Conditioning of South FL
City: Jensen Beach, FL State:
Zip Code: 34957 Fax:
Phone No. (732) 425-0361
Address: 1413 SE Conference Cr
City: Stuart State: FL
Zip Code: 34997 Fax:
Phone No561-515-5527
E-Mail:vmaxie15@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail adam@arnoldsairconditioning.net
State or County LicenseCAC1814146
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: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: _ Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
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
TWICE FOR IMPROVEMENTSiiEN�EY
POSTED ON T JOB SITE
WITH YOUR DER OR AN
as
A NO ICE OF COMMENCEMENT MAY RESU
rY. JYNOTICE OF COMIMEY9EMENT MU BE
ION. IF YOU INIZW TO OBTO FINA
CO INC YOU OF COMM MENT
of Contractor,
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF _ &&2_29a6h JCOUNTYOF &4
The forgoing instru ent was acknowledged before me
this day of i/ / 20a by
Name of person making statement.
Personally Known L/ OR Produced Identification
Type of Identification
Produced
YOUR
AND
The forgoing instrunlent was acknowledged before me
this f' day of 20_i by
lyfp� &�/� t,
Name of person of person making �statement.
Personally Known AOR Produced Identification
Type of Identification
Produced
IQA�l -T /)21 akt
(Signa ure of Notary Public- §tate of Florida) (Signature of Notary Public- State of Florida )
Commission No. 6L2& T7 (Seal)
Commission No. 6&31/8t3:9� (Seal)
REVIEWS FRONT;" l VG(;JD fi$JLP $ 4"?7 PLAN'S VEGE14T "F'_SEkNII ITVASU 411MI NGROVE
COUNT VEX 5:,4'2 REVIEW RE +Jane $, QMEW
DATE ''f� mt "`� oil T6fa Am No fy Y r'u i nt '`� fa Now/
RECEIVED
DATE
COMPLETED