HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/2/2021 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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 9200 One Putt Place Club House
Legal Description: Island Club House
Property Tax lD#: 3334-501-0005-000/8 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out like for like replacing Lennox 2 speed,3ton ac unit with Bryant 2 speed 3 ton AC,
condenser 127ANA036, and air handler FV4CNF003L00, 16 SEER, 5 kw heat.
CONSTRUCTION INFORMATION:
Additional work to a er Dime un er t is permit—check a apply:
❑✓_HVAC ff Gas Tank Gas Piping _Shutters a Windows/Doors
Electric El Plumbing Sprinklers Generator El Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ $5600.00 Utilities:0 Sewer[]Septic Building Height:
OWN E R/LESSEE: CONTRACTOR:
Name PGA Village POA Inc. Name: Keith Thompson
Address:2140 Reserve Park Trace Company: AC Keith Inc.
City: Port St Lucie State:FL Address:
Zip Code.. 34986 Fax:n/a City: Port St Lucie State:FL
Phone No.561-276-4500 Zip Code: 34953 Fax: n/a
E-Mail: Phone No. 772-519-1351
Fill in fee simple Title Holder on next page( if different E-Mail: ackeithl@att.net
from the Owner listed above) State or County License: CAC1813976
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: 4 Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: ^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 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
commencing work or recording our Notice of Commencement.
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Signature o wner/L ssee antractor as Agent for Owner Signature of Contractor/Licen Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OFd1� COUNTY OF ► � f
The forgoing instrufiRent was acknowledged before me The rg ing instru nt was knowledged before me
this day of 20j;�- by this day of 20 F( by
Name of person making statement f Name of person making state ent
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification r Type of Identificatign
Produced—EL- ()/ L Produced T L-04
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(Signature of to (Signaturg�of otary Pub1-7
CARLAI.COULT@R CAALAI.COL'LTER
COmmis5lon O. + : fir = NotaryPub'.i��$ �ofFiorido Commis ' No. ' Nonrf 5idteofFlo da
Commission-C-G 142 441 ,' Commission:CG i42441
My Conm,Expires Oct 30,2021 ,Comm.Expires Oct 50.2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17