HomeMy WebLinkAboutAnderson_ Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/01/2020 Permit Number:
S:L
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR:AC Changeout
PROPOSED IMPROVEMENT LOCATION: r=.
Address: 9650 S Ocean Drive, Unit 406, Jensen Beach, FL 34957
Property Tax ID #: 4502-610-0036-000-7 Lot No._
Site Plan Name: n/a Block No.
Project Name: n/a
DETAILED DESCRIPTION OF WORK:
Like for Like AC Changeout. Installing BOSCH -4-Ton Water source heat pump.
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:
Cost of Construction: $ 3,100.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Barbara Anderson
Name: Kim Wilson
Address: 9650 S Ocean Drive , Unit 406
Company: Premier Plumbing and Air
City: Jensen Beach, FL State: _
Zip Code: 34957 Fax:
Phone No.772-486-0745
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
it value of construction is Z500 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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address;
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: T,
City: T State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Address'
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVCr: Application is hereby made to obtain a permit to do the work and installation as indicated.
Fcertify 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, watts, 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 YOUR PAYING
TWXE FOR I TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST R SPECiION. IF YOU INTEND TO OBTAIN FRIiANC04G, CONSULT
WffH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:"
Signature of Owner/ Lessee/Contractor as.Ageritfor Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFT : t^t'- COUNTY OF
T4 f rjgping instrun nt was acknowledged before me
this day of 20 Xby
Name of person making statement.
Personally Known/ OR Produced identification
Type of Identification
Produced
(Signatur of Notary P ic- State of FI a }
Commission
C4apab"10662161114
REVIEWS
COUNTER ( REVIEW I REVIEW
{ DATE
RECEIVED
DATE
i COMPLETED
The fq r Ing instru nt was acknowledged before me
this �. a day of _.¢"� — 206 by
Name of person making statement.
Personally Known^ OR Produced Identification
Type of Identification
Produced
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(Signature of Notary Public- State of Florid
Commission 46ARTAlh, M41L' 4MH
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PLANS ( V = GROVE
REVIEW I REVIEW REVIEW I REVIEW