HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/28/2020 Permit Number:
LUC1r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
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 1703, Jensen Beach, FL 34957
Property Tax ID#: 4502-602-0157-000-6 Lot No.
Site Plan Name: n/a Block No.
Project Name: n/a
DETAILED DESCRIPTION OF WORK:
Like for Like AC Changeout. Installing BOSCH 3-Ton water source heat pump AC Unit.
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 _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 Patrick Flugger Name: Kim Wilson
Address: 9500 S Ocean Dr- Unit 1703 Company: Premier Plumbing and Air
City: Jensen Beach, FL State:_ Address: 108 NE Dixie Hwy
Zip Code: 34957 Fax: City: Stuart State: FL
Phone No. 347-447-1375 Zip Code: 34994 Fax: 772-692-1094
E-Mail: n/a Phone No 772-692-2500
Fill in fee simple Title Holder on next page( if different E-Mail preplbgac@gmail.com
from the Owner listed above) State or County License CAC-033574
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.
' DESfCiNE SNEER; ____Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address: —
City: State: City:
Zip: Phone Zip: ---
Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: _Not Appiicab e--
Name: Name:
Address: Address'
City: , City:
Zip: Phone: I Zip; Phone: —_-
I
OWNER/CONTRACTOR AFRB1f, Application is hereby made to obtain a permit to do the work and installation as indicated.'
!-certify that no work or installation has commenced prior to the issuance of a permit,
St. Lucie County makes no representation that is gimnting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Horne Owners Association rules,bylaws grand covenants that may restrict or prohibit such
structure. Please consult wrth 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 auilding Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,switrnrting posts,fences,walls,signs,screen rooms and accessory uses to another non-residentia l use
"WARNING TO OWNER: YOUR FAfL,URE TO RECORD A NOTICE OF MAY RESULT IIII YOUR PAYING
TEE FOR Mit Q VENIIENISm TO YOEIR PROPERTY. A NOTfEE OF IIIIIIIIIIIIENCEMENT NWT BE RECORDED AND
POSTED ON THE JOB SITE SOON THE FIMST 09WEC FWK IF YOU INTEND TO OBTAIN FIINANCBMG, CONSULT
`"M YOUR:LENDER OR AN ATTAiREY BOOK RECORDW YOM NOTICE OF COMMENCEMENT."
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
I STATE OF i
AUNTY pFC1RIDAFLORIDA
j COUNTY Q _/ ,t� ---
The forgoing instrument s acknowledged before me The for ng instru e as acknowledged before me
this day of_ r� 20 Eby this day of_C�c 2ff �by
Name of person making statement. Name of person making
statement.
Personalty Known�_OR Produced Identification Personally Known c/ OR Produced Identification
Type of identification Type of Identification
Produced Produced
o
(Signatur of Iilotary P _ ic-State of j
(Signature No"Pubk-State of Florid
' Commission CommissionSeal}
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REVIEWS RVISOR PLANS EST GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW I REVIEW �
DATE —�
RECEIVED
DATE
i COMPLETED
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