HomeMy WebLinkAboutRoeder_ AC _Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/01/2021 Permit Number:
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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:AC Change out
PROPOSED IMPROVEMENT LOCATION:
Address: 9500 S Ocean Drive, Unit 1510, Jensen Beach, FL 34957
Property Tax ID #: 4502-602-0144-000-2
Site Plan Name: n/a
Project Name: n/a
Residential x
Lot No._
Block No.
I DETAILED DESCRIPTION OF WORK: I
Like for Like AC changeout. Installing 3.5 Ton BOSCH water source heat pump. No KW.
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: $ 2,400.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name James Roeder
Name: Kim Wilson
Address: 9500 S Ocean Drive
Company: Premier Plumbing and Air
City: Jensen Beach,FL State: _
Zip Code: 34957 Fax:
Phone No. n/a
Address: 108 NE Dixie Hwy
City: Stuart State: FL
Zip Code: 34994 Fax: 772-692-1094
Phone No 772-692-2500
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail preplbgac@gmail.com
State or County License CAC-033574
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.
Name: lu��
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
�Xddress:
City:
Zip: Phone:
MORTGAGE COM AI Y: _ Not Applicable
Name: Ift
Address:
City: State:
Zip: Phone:
BONDING COMPANY: ^Not Appiicabie
Name.
Address'
City:
Zip: Phone: -- --
OWNER/ CONTRACTOR AFRMT: Applcaftn is hereby made to obtain a permit to do the work and installation as indicated.
1-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 arty applicable Hem OwFers Assocctation rules, bylaws oran covenants that may restrict or prohibit such
structure. Please consult wrth your Home Owners Association and review your deed for any restrictions which may apply.
'ilrT', ,onsideration of the granting of this requested permit, I do hereby agree that 1 will, in ail respects, perform the work
-in accordance with the approved plans, the FWda Building Codes and St. Lucie County. Amendments.
The following building permit ap:plicatwns acre ex~ from undergoing a full concurrency review: room additions,
accessory structures, swinmring poo4s, fenms, wale, signs, screen rooms and accessory uses. to another non-residential use
"WARNING TO OWNW YOUR FAILURE TO RR V 91 A NOTICE OF ENT MAY RESULT IN YOUR PAYING
TV4CE FOR M_R__ 31111111111 TO YOUR PROP119W. A NOTXE OF MUST BE RECORDED AND
POEM ON TIM JOB SFIX M FIRST 111195INECTION11. IF YOU INTEWTO OBTAIN FINANCING, CONSULT
`mTH YOtJa u3m= OR AN Anon= som 1im Riow Yom Nowx OF "
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Signature of Owner/ Lessee/Contractor as Agent for Owner
� Signature of Contractor/License Holder
j STATE OF FLORIDA jC
£AUNTY OF c �`
QF£lRiDA_
COUNTY 7
The fgping rostrum, nt was acknoarlec#ged beft3re me
this 1� day of � A. 20J by
The f going instru t was a knowledged before me
this PT day of r 20 ( by
Name of person making statement.
Flame of person making statement.
Personally Known-' dR Produced Identificatian
Personally Known OR Produced Identification -
Type of Identification
Type of Identification
'f Produced
I
Produced
i
tsignatur cf fury rc= Staie of FW&3
(Sigriateare Noe ry Public- State of Florid 1
Commission IRtY
! commission ►Seal)
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REVIEW REVIEW
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REVIEW
I DATE
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RECEIVED
i
DATE
COMPLETED
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