HomeMy WebLinkAboutKaplan 1324 PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
Uo L4UCE,1E5
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 1324 NW Lancewood Terr
Property Tax ID #: 4426-804-0017-000-0
Site Plan Name:
Project Name: Kaplan
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK: I
Install a new 4 ton 16 seer 10kw Rheem complete system
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: $ 6636.00
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameSusan Kaplan
Name: Luke Walker
Address:1324 NW Lancewood Terr
Company: Treasure Coast Air Conditioning
City: Palm City State: _
Zip Code: 34990 Fax:
Phone No. 772-212-7337
Address: PO Box 460
City: Jensen Beach State: FL
Zip Code: 34958 Fax: 772-288-7046
Phone N0772-692-1701
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailTCAC1990@gmail.com
State or County License CAC058476
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL 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:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recoWiQg your Notice of Commencement.
Signati, Vofne Lessee/Contractor as Agent for Owner
Signa ense Holder
STATERIDA ��Tiv
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ST FLORIDA
COUNTY OF
COUNTY OF
Swor o (or affirmed) and subscribed before me of
Swor o (or affirmed) and subscribed before me of
Physical Presencg_2 r Online Notarization
p-.
Physical Presencor Online Notarization
this 9' day of J (.w- , 2020 by
this ___V day of �J-A,C2020 by
Name of person making statement.
Name of person making statement.
�OR
Personally Known OR Produced Identific,11MI1.,Personally
Type of
Known Produced Identification
Type of Identification
ddentification �H R/S � ii
Produced
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Commission No. y3ydo4 �;'
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REVIEWS
FRONT
ZONING
��OWC`OR
PLANS
VEGETATION
SEA TURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20
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