HomeMy WebLinkAboutpermit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/08/2021 Permit Number:
c ° Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Mechanical
PROPOSED IMPROVEMENT LOCATION;
Address: 10725 S Ocean Dr. Lot 507 Jensen Beach, FL 34957
Residential X
Property Tax ID #: 4511-502-0001-000-9 Lot No. 507
Site Plan Name: Holiday Out At St Lucie -Sec B Block No. M
Project Name: Michael Kemp
[DETAILED DESCRIPTION OF WORK:
AC change out 4 ton Lennox 16 seer Air Handler- CBA25UHV-048-230 Condenser- ML14XC1-047-230A
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: $ 7328.00
Sq. Ft. of First Floor:
Utilities: —Sewer — Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Michael Kemp
Name:Stephan S Buckley
Address:10725 S Ocean Dr Lot 507
Company -AC All Stars, LLC
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No.772-631-3859
Address:21280 Rock Ridge Dr.
City: Boca Raton State: FL
Zip Code: 33428 Fax:
Phone No561-405-5446
E-Mailsfaa4995@aol.com
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County LicenseCAC1817509
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.
one
DESIGNER ENGINEER:
Not Applicable
MORTGAGE COMPANY:
^ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name: —
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao the worK anu ms[allauvn as mul-ar.eu.
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
ssttructur'e. Please co consult until your Home Owners Associationandnd review your deed for
any rest�nCiio s which ay aprohibit such
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
.. a _ _ Commencement.
VY I'll
Signature of Owner/ Lessee/Counr as Agent for Owner
Signature of C actor/Licen older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFP-1-
COUNTY OFP*-Bftach
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or x Online Notarization
X Physical Presence or Online Notarization
this 6 day of March2021 2.020 by
this a day of 2021 .2020 by
Wdlael Kemp
sisphan S Buckley
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification x
Personalty Known x OR Produced identification
Type of identification
Type of Identification
Produ a "510-54"'46°
Produce
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Commission No. HH075246
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Commission No. �' 8anaed rnl Y Assn,
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BonrMd fhrouq� Nlborat IbtuYAun.
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