HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/3/2021
Permit Number:
91ro LIEC�GC
V
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial xx Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 9501 BRANDYWINE LANE
Property Tax ID #: 3327-803-0005-000-3
Site Plan Name:
Project Name: TUTTO FRESCO
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE AC CHANGEOUT - 5 TON LENNOX SYSTEM - 14 SEER - 10KW HEATER
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional ork to be performed under this permit— check all that apply:
L-Zechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 6,500.00
_ Generator
Lot No.
Block No.
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
� OWNER/LESSEE: I CONTRACTOR:
NameV AND F WEST LLC
Address:2891 SW BUTTERFLY LANE
City: PALM CITY State:
Zip Code:34990 Fax:F
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Roof Pitch
Building Height:
Name:PHILIP NISA JR
Company: NISAIR AIR CONDITIONING
Address:3700 S. US HIGHWAY 1
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-468-8945
Phone No772-466-8115
E-Mail KRISTIN@NISAIR.COM
State or County LicenseCAC041199
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.
SUPPLEMENTAL CONSTRUCTION. LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ 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: 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 roncurrencyleview__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
improve is to your property. A Notice of Commencement m be recorded in the public records of St.
Lucie C nt and posted on the jobsite before the first inspectio .1 you intend to obtain financing, consult
with le clgr r alltto ey before commencing work or recordin y rAoUre pf Commencement.
Signature
STATE OF FLORIDA
COUNTY OF STLUCIE
as Agent for Owner
Signature of
STATE OF FLORIDA
COUNTY OF STLUCIE
Ol
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
xx Physical Presence or Online Notarization
xx Physical Presence or
Online Notarization
this 3RD day of MAY 10-7I by
this 3RD day of MAY
2i; ')by
PHILIP NISA A
PHILIP NISA A
Name of person making statement.
Name of person making statement.
Personally Known xx OR Produced Identification
Personally Known xx O
Produced Identification
Type of,ldentification
Type of Id ntification '
prod ed j
Produce
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