HomeMy WebLinkAboutGuimond Permit 5-10-21All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/10/2021 Permit Number:
95r LLCLr
1 0 a ° " " - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: A/C Change Out Like for Like
PROPOSED IMPROVEMENT LOCATION:
Address: 10725 S. Ocean Dr., #407, Jensen Beach, FL 34957
Property Tax ID #: 4511-502-0122-000-3 Lot No. 5
Site Plan Name: """' " ' "" Block No. "
Project Name: Guimond
DETAILED DESCRIPTION OF WORK:
A/C Change Out Like for Like `
2.5 Ton, 14 Seer, & 8 KW
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additio workto 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: Sq. Ft. of First Floor:
Cost of Construction:$ 3292.00 Utilities: _Sewer _Septic Building Height:_
OWNER/LESSEE:
CONTRACTOR:
NameGuimond, Peggy
Name: Daniel Shawver
Address: 10725 S. Ocean Dr., #407
Company: DS Air Conditioning, Inc.
City, Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No.508-439-2671
Address: P.O. Box 197
City: Jensen Beach - - State: FL
Zip Code: • 34957 Fax:
Phone No 772-335-4531
E-Mail:
Fill In fee simple Title Holder on next page(If different
from the Owner listed above)
E-Mail info@dsairconditioning.com
State or County License CAC058716
it value or construction u Z Uis 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:
Name:
_Not Applicable
MORTGAGE COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
Zip: Phone
State:_
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER:
Name:
_Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 ermit will authorize the permit holder to build the subject structure
which Is In conflict with any applicable Home Owners Assoc ation rules, bylaws or an 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.
Inconsideration 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first ins ection. If you in to obtain financing, consult
alto fore commencingwork o recor In tice of Commencement.
Signatur Owner/ Lessee/font or as Agent for Owner
Signatu f Contractor/ ense Holder
PATE OF FLORIDA
ATE OF FLORIDA
UNTY OF
COUNTY OF
Swryn to (or affirmed) and subscribed before me of
to
Sworn to (or affirmed) and subscribed before me of
+/ Presence or_ Online Notarization
LZ Physical Presence or Online Notarization
this 1O day off .2026 by
this JCft day of " .2024 by
D3niei Shau2VCC
Daatiel SV wailer
Name of person making statement.
Name of person making statement.
I/
Personally Known V/ OR Produced Identification _
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signatu of Nota blic-State of Florida)
(Signature o#Ao
•",'."!yN'•., MARGARET J. CULBERTBON
Commission No. •• MAR 3. ULBERTSON
Commission No. 'r' MY COMMI65763E
%A MY COMMISSION N GG 097638
i EXPIRES: Jufie t7. Zazt
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Rev. 5/b/20