HomeMy WebLinkAboutArbelaez_ permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/14/2020 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:AC Changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 9500 S Ocean Drive, Unit 1009, Jensen Beach, FL 34957
Property Tax I D #: 4502-602-0093-000-9
Site Plan Name: N/A
Project Name: N/A
Residential X
Lot No._
Block No.
I, DETAILED DESCRIPTION OF WORK: , MIMES I
Like for Like AC Changeout. Installing BOSCH 2.5 -Ton - Water Source Heat Pump
New Electrical Meter Second Electrical Meter
NSTRUCTION INFORMATION `
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2,300.00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William Arbelaez
Name: Kim Wilson
Address: 1030 NW 106th Ave
Company: Premier Plumbing and Air
City: Plantation, FL State: _
Zip Code: 33322 Fax:
Phone No.305-613-1572
Address: 108 NE Dixie Hwy
City: Stuart State: FL
Zip Code: 34994 Fax: 772-692-1094
Phone No 772-692-2500
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
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESiIGMERjENGfNEER:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address: 4116
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 yvith any applicable Home Owners Assocation 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 popls, fence,, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNIM TO OWNESE YOUR FANS TO RECOM A NOTICE OF MAY RESULT IN YOUR PAYING
TWICE FOR gIrMOVEME ITS TO YOUR PROP"IWTY. A NOTKE OF C MUST BE RECORDED AND
POSTED 010 THE .RI® SITE BEFOW THE FIRST ]INSPECTION. IF YOU IIIti NO TO OBTAMI MANCING, CONSULT
WFI N YOUR: LENIM .OR AN ATfOFMV 884M RECoRoW YOUR NOTICE OF CO i10EMENT. "
Signature of Owner/ lessee/Contractor as.Agent for Owner
l
Signature of Contractor/License Holder
STATE OF FLORIDA ( /
STATE OF FLORIDA
COUNTY OF cam` : h 1
COUNTY OF 7
The ing instrume was ycknowled
forggd before me
this day of 200 by
The�tng inxtrum was cknowledgetbefore me
this day of. _ by
I m U 1ST,
i �i ors
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
i
Produced
I
(Signat7ur4 of Notary P ic= State of Fl j
(Signature Notary Public- State of Florid
{.OmmE5510n Q .. r.
i
commission � BRUM LEY alj
- Exipi+aAlrif7,212
REVIEWS
ERVISOR
PLANS
V
GROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
III
DATE
1
COMPLETED
nCv. Lf // 17