HomeMy WebLinkAboutKaufman_Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/29/2021 Permit Number:
S5,-L [ < TCLlL
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 Changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 7400 S Ocean Dr, Unit 704, Jensen Beach, FL 34957
Property Tax ID #: 3522-606-0027-000-7
Site Plan Name: n/a
Project Name: n/a
DETAILED DESCRIPTION OF WORK:
Like for like AC Changeout. Installing 2.5-Ton TRANE unit, 14 Seer.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
Lot No.
Block No.
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:
OWN ER/LESSEE:
CONTRACTOR:
Name Carolyn Kaufman
Name: Kim Wilson
Address:10019 Dublin Rd
Company: Premier Plumbing and Air
City: Walkersville, MD State: _
Zip Code: 21793 Fax:
Phone No.301-845-9866
Address: 108 NE Dixie Hwy
City: Stuart State: FL
Zip Code: 34994 Fax: 772-692-1094
Phone No772-692-2500
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 LicenseCAC-033574
It value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Wc.H%WVC rtfe iiil�fEEii; — Not Applicable
Name:
Address �
City. State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address: �}
City: State:
Zip:
BONOING COMPANY: Not Applicable
Name:
Address.'
City:
ZiP: Phone: —
OWNER/ CONTRALToR AFFII€ MT: ed
icaVon is hereby made to obtain a permit to do the work and installation as inCiic3t2d.
Fcertify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countymakes no representation that is grv"g a permit will authorize the permit holder to build the subject structure
which is in conflict*th arty applicable Herne Owners Association rules, by}ays orandcoMants that may restrict or prohibit such
structure. Please consult wrtlt your Hvme Owners Association and review, your deed for any restrictions which may appiy.
-lirl;ponsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
iin accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building Permit applications are Oxerript from undergoing a full concurrency review: room additions,
accessory structures, swltwrtir9 poycsls, ferifts, %calls, signs, screen rooms and accessory uses to another non-residential use
` WARt1 WG To 0wNIM YOUR IFAMI URE. T8 A NOTICE OF T MAY RESULT M YOUR PAYINC
TWIM FM . TO Y" Pnop% iY. A N07XE OF COFAFAEmCEMEW MUST I&E RECORDED AND
POST® ON THE .ION SITE 890K TIM FWAST affiWK M IF YOU INTEW TO OBTAMl FWANCING, CONSULT
J!"i ! OR AN A'tT$p1M SWIM MMOROM N071CIE OF COMMEMCEMENT ."
L. �J 4Le�or�
I Signature Of Owner/ Lessee/Contractoras. ftent'for owner
} STATE OF FLORIDA
COUNTY OF S�
The fQrggi_ng instrum t s acknowledged before me
this
d �l day cad ��, 202 by
Kim
Name of person making statement.
t
Personally Known A/ OR Produced tdentifigiion
1 Type of Identification
'l Produced
jsignatur of Gary ic---State of
Corn
cumb"#9B M
REVIEWS
COUNTER I REVIEW 1 REVIEW
RECEIVED
DATE
Signature of Contractor/License Holder
STATE OF FLORIDACOUNTYOF 7
The f9R,r instrum acl owledged before me
thimy / 20� by
Name of person making statement.
Personally Known _ OR Produced Identification i
Type of Identification
Produced
(Signature or No" Public- State of raorid
Commission tJ%tjP%.&. AIML84AM
PLANS lGROVE
REVIEW REVIEW REVIEW I EVIEW