HomeMy WebLinkAboutSTEAMWORKS.PERMIT APP22_.9b 1 if ! C'111711 /44-V J
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/2/21 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 X Residential
PERMIT APPLICATION FOR: A/C CHANGE OUT
I PROPOSED IMPROVEMENT LOCATION:
Address: 8705 US-1 S. ( 8705 S. FEDERAL HWY , PSL 34952)
Property Tax ID #: 3 "c _�S CA Lot No.
Site Plan Name: STEAMWORKS COFFEE BAR Block No.
Project Name: STEAMWORKS COFFEE BAR
DETAILED DESCRIPTION OF WORK:
A/C REPLACEMENT - INSTALL 2.5 TON, 14 SEER. M#RA1430AJ1 NA, M# RH1 P3017STANJA
8KW
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
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ S�Q.
c�a
_ Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Q,J
Name: Joshua Roberts
Address: S
Company: DOCS OF THE TREASURE COAST, INC
City: �_��i'}cf State: �
Zip Code: c�T 1;��- Fax:
Phone No. %7a, n( S - '7
Address: 866 12TH AVE SW
city: Vero Beach State: FL
Zip Code: 32962 Fax:
Phone No (772) 713-7716
E-mail: S4W,vrvJ a
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail AIR DOCS_ADM@YAHOO.COM
State or County License #1 2702/RA1 3067525
_•-•_-- _• 1w••—1-1. up 111u1c, d Rc%-unucu IMozIce or commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:_
Address:
City: _
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
State:
_Not Applicable
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 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 r an attorney beforpe)ommencing work or recordingvour Notice of ommencement.
'ZA
Signature Own r/ Lesse ontractor as Agent for Owner
Signature Contractor/ Lic nse Holder
STATE F FLORIDA
STATE OF FLORIDA
COUNTY OF :3LRt>�. �LiP�-
COUNTY OF Indian River County
Swore to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this > day of 202p by
this 2 day of FEBRUARY 2020 by
GI/1t.La (V' �ad4— 5
Joshua Roberts
Name of person making• statement.
Name of person making statement.
Personally Known Produced Identification
Personally Known x OR Produced Identification
Type of tification
T e of I ntification
Produ d
l oduced
(�611�
0
(Signatur (o PELL
a I
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MMISSION # GG 170551
V.
ISSION # GG 170551
Commission ": P° EXPIRES: r�7 ,2421
dedNotary F'ubc UnvritersI
Commissi P EXPIRES: December 25{k211)
Public Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
nev. 5/b/ LU