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HomeMy WebLinkAboutPermit application LearyALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3/11/2021 Permit Number: Building Permit Application Plonning 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: Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 8733 Tompson Point Road Legal Description: Tompson Point Pud at PGA Village Property Tax ID #: 3327-704-0038-000-9 Site Plan Name: Project Name: Setbacks Front Back: I DETAILED DESCRIPTION OF WORK: Right Side: Left Side: Lot No. Block No. Change out like for like 4 ton unit, 16 SEER,10KW heat, Carrier Condenser CA16NA048, Air Handler FX4DNF049 CONSTRUCTION INFORMATION: Additional work to be nertormed under this permit — check all that apply: nHVAC Gas Tank I Gas Piping _ Shutters a Windows/Doors 11 Electric Plumbing Sprinklers E Generator 1:1 Roof C� Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ $4700.00 5 Ft. of First Floor: Utilities: Sewer 0 Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name William and Diane Leary Name: Keith Thompson Address:8733 Tompson Point Road Company: AC Keith Inc. City: Port St Lucie State: FL Zip Code: 34986 Fax: nla Phone No. 847-922-1265 Address: 690 SW Pueblo Terrace City: Port St Lucie State: FL Zip Code: 34953 Fax: n/a Phone No. 772-519-1351 E-Mail: ackeithl@att.net E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License: CAC1813976 If value of construction is 52500 or more, a RECORDED Notice of Commencement is requirea. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable I MORTGAGE COMPANY: Not Applicable Name: Address: City: Zip: Phone State: FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone:_ Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: City: 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 co en in work or rec inspection, our Notice of Commenceme U Signature of Owner/ Les a/Contractor as Agent for caner Sign ture of Contractor/License STATE OF FLORIDQ�. STATE OF FLORIDA_A 5J_ L�•t,�L COUNTY OF 1 i�C-�� _ COUNTYOF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this \( day of _ �c r \ _ 2Q-k by this �( day of .60�cLrJ 20_)A by K-e\ �"\ ' 1 Flo:M P '�©c-, "i+ 4h l'- P SO"') Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification f _ Produced %ol � l _ P� � �U Type of Iden ification Produced I.OI. T� i y j I ure of Notary Public- State ture of Notary Public- S715-ida)-RA-iC_SCo MAS071 I Commission No.4-i7' 1a� FiiANCE5C0 MASU �aJ) Notary Public -State of �` # GG 26 I F0* 37t ) at-. ? Pubic State of Florida ': issionNo Ir)IiS�_ (Se l issior, ; GG 265371 ?�or�o; Nov 5, 202: Commission. My Ccmm. Expires °F. My Comm. Expires Nov , 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17