HomeMy WebLinkAboutBaker, Clyde SLC - Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1f21121 Permit Number:
N*M
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, FotI Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: HVAC
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential X
Address: 10725 S OCEAN DR, Unit 99 Jensen Beach, FL 34957
Property Tax ID q: 4511-501-0302-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Baker, Clyde - Like for like ac change out
I DETAILED DESCRIPTION OF WORK: I
Like !et At- 21on Luxane ac system wnge out with no duct wc,k uvng A4U k1odc1AVC2413X21. CU W(M TC482422Y — • .,
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
XMechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4,259.00
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Baker, Clyde
Name: ROBERT CAMPBELL
Address: 10725 S OCEAN DR, Unit 99
Company: BUILDING TECHNOLOGY SERVICES
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No.
E-Mail: cbframing@hot.hotmail.com
Address: 7886 SE ELLIPSE WAY
City: Stuart State: FL
Zip Code: 34997 Fax:
Phone No 772-600-7151
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail SUPPORT@BREATHEHEALTHIERAIR.COM
State or County License CAC058685
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: be Not Applicable
BONDING COMPANY: ,KNot Applicable
Name:
Name:
Address:
Address:
City
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVff: 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 anYYa�pplicable Home Owners Assodation rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult wtti� 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
"WAS TO OWNHE YOUR FAB.URE TO RECORD A NOTICE OF COMMICEIIIENT MAY RESULT IN YOUR PAYING
TWICE FOR INPROVENENTS TO YOUR PROPERTY. A ALIEOT110E OF W BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST AL IF YOU WTEND TO WFAIIII FII MAC01A, CONSULT
v►rru vnum utwinm nQ em Ai rniaxmr eFFinm UNDIM TCHM INSTIEF OF CO29MENEENHUA
Signature of Ow er ssee/Contractor as Ae* fer Owner
Signature of Contractor/Lic a older
STATE OF FLO A
COUNTY OF `Yl
STATE OF FLORIDA
COUNTY OF 17Y.61`rn
The forgoing Instrument was acknowledged before me
The
day of 2QJ ) by
The forgoing instru ent was acknowledged before me
this day of 20 of by
Name of person making statemifint.
Name of person making state ent.
Personally Known _ OR Produced Identification
Personally Known )g OR Produced Identification
Type of Identification
Type of identification
Produced
Produced
t 0LVI1 DQAND
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(S 10 it—ure of Public- S g oG 3338w
a n ay C=m. Exaim fay • 3. i4
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Commission No. �7� �
tore of Nob u ic- S M8c •state
3 + GG 733870
� � Extres May 13. 20
mission No. kational ��
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.1/ 7719