HomeMy WebLinkAboutBuilding Permit Application OCT/01/2020/THU 10; 44 AM FAX No, P. 001
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO HE ACCEPTED ad\p p d3
Date: 10/01/2020 Permit Number:
° OCT 01 202'13L`::,. �:.� ...•.:.:.'; �.:.: • . . Building permit Applicatio
Planning and Development Services ST. Ldcie Cou y ermitting
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 349a2
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: v ��
Address: 5711 Sunberry Cir Fort Pierce, FI 34951
Property Tax ID#: 1312-502-0184-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
5,0 Ton 15 Seer Straight Cool Split System
10 KW Heater
Like for Like
New Electrical Meter Second Electrical Meter
EMININNEENMEM
Additional workto 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:$ 7100 _ Utilities: _5ewer _Septic Building Height:
L R
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Name Voltaire Henrius Name:Robert Marcelle
Address:5711 Sunberry Cir Company:Comfort Experts USA Inc
City: Fort Pierce State:_ Address:664 NW PEnterprise Dr.Unit 120
Zip Code: 34951 Fax: City: Port Saint Lucie State:FL
Phone No.772`466-9163 zip Code: 34986 Fax:772-873090
E-Mail: Phone N0772-873-3000
Fill In fee simple Title Holder on next page(if different E-MailCkongerl4@gmaii.com
from the Owner listed above) State or County License CACI 814439
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.
OCT/01/2020/THU 10:44 AM FAX No. P. 002
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 AFFIDVIY: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,•wells,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 recording our Notice of Commencement.
Signature of Owner/Lessee/ c tractor as Agent for owner Signature of Contr or/License Holder
STATE OF FLORIDA ( STATE OF FLORIDA 01 /'.0
COUNTY OF l Gl` COUNTY OF
Sworn to(or affirmed)and subscribed before me of 5w rn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Present or Online Notarization
this�day of,��? _� 2020 by this day of �— 2020 by
��(L'PA 4 M, CA I e-�, T Mo
Name of person making statement. Name of person making statement.
Personally Known OR produced identification. Personally Known OR Produced Identification
Type of Ir tification Type of ideI-v�fi tion rr
Prod Produced n � V1 U(!A i�_�
rhk, cajn_62z��. / Y V K
(Signature of Notary Publi 0nature of Notary Public-State of Florida)
HEHiNE MILLS
':State of Florida-Notary Pu it
commission No. Ll d6ftAission#-GG 27331 � mission No. �,�r
My Commission Expire `'� r� �_5tat T RINE MIf,LE
" `" Novemfaar 01,2022 a of Florida-Not li
5 �,� ission#GG27331
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COUNTER REVIEW REVIEW REVIEW REVIEW
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