HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/15/2021 Permit Number:
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
Address: 3037 Five Iron Drive, Port St Lucie, FL 34952
Legal Description; Savanna Club
Property Tax ID #: 3425-707-0093-000-2
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
Change out like for like 4 ton package unit, 14 SEER,10KW heat, Carrier package unit 50ZPC048
CONSTRUCTION INFORMATION:
Additiona I work to e ertormed under this permit —check a apply:
�HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
Electric F]Plumbing OGenerator
Sprinklers Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ $5000.00
Sq. Ft. of First Floor: _
Utilities: 0 Sewer E Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Walter and Virginia Nygard
Name. Keith Thompson
Address: 3037 Five Iron Drive
Company: AC Keith Inc.
City: Port St Lucie State: FL
Zip Code: 34952 Fax: nla
Phone No. 772-873-8580
Address: 690 SW Pueblo Terrace
City: Port St Lucie State: FL
Zip Code: 34953 Fax. nla
Phone No. 772-519-1351
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: ackeithl@att.net
State or County License: CAC1813976
IT vaiue oT construction is �>Z51JU or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City., State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenciAg w.oryor recordingY-ov4-Notice of Commencement. %% ,. J
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Signature of Owner/
STATE OF FLORIDA
COUNTY OF
r as Agent for Owner
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The forgoing instrument was acknowledged before me
this jL day of 20 2 by
17-h)/_Y7 soh
Name of person making statement
Personally Known OR Produced Identification IX
Type of Identification
Produced PG . I—L -
(Signature of Notary Public- State of Florida
Commission No .3 x Z �� (SE
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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Signatdre of Con censeT-1 older
STATE OF FLORIDA Cam%
COUNTY OF �
The forgoing instrument was acknowledged before me
this / / day of 7a174Ja n4 20 Zr by
Ate' T_ n
Name of person making statement
Personally Known OR Produced Identification X
Type of Identifiation
Produced / Z_ L
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SUPERVISOR PLANS I VEGETATION I SEATURTLE
REVIEW I REVIEW REVIEW REVIEW
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Commission # GG R
Comm. Expires Aug
MANGROVE
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