HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: ��
RECEIVED
Building Permit Application
Planning and Development Services Permitting•Department
Building and Code Regulation Division st.Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPEWC Change out
PROPOSED fiMPRQUEMEN C LOCATION'v i
Address: 3603 Avenue O, Fort Pierce, FL 34947
Property Tax ID#: 2405-601-0396-000-6 Lot No.6 &7
Site Plan Name: Block No. 22
Project Name: Singleton-AC Change out
DETAfLEIa DESCRIPTIfJN Q�WORK � � E� 4
k r:
A/C Change out S E%2_ 13 -MN Z 5 K iVJ
CONSTRIlCTIOI�kINFpRMATION� �' � � � � �
Additional work to be performed under this permit—check all that apply:
X Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 1,508 sqft living area Sq. Ft.of First Floor: 1,508 sqft
Cost of Construction: $ 7,353.00 Utilities: —Sewer —Septic Building Height:
Name Edith Singleton Name:David Zamarripa
Address:3603 Avenue O Company:DAVID HEATING&AIR CONDITIONING, INC.
City: Ft Pierce , FL State:_ Address:116 North Lime Street
Zip Code: 34947 Fax: City: Fellsmere State:FL
Phone No.772-342-0587 Zip Code: 32948 Fax:
E-Mail: Phone No 772-713-9997
Fill in fee simple Title Holder on next page( if different E-Mail Zamarripa902@gmaii.com
from the Owner listed above) State or County License CAC1817681
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.,
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
5UPPLEMENTALCONSTRUCT;ION�LIEN LAW INFORNIATI(JN
DESIGNER/ENGINEER: x 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y UR LENDER OR AN ATTORNEY BEFORE RECO DINGXOUR NOTICE OF COMMENCEMENT."
1
Signature of Owner/Less Contractor as Ag nt for Owner Signature of Cr ntractor/License H Ider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Xaral.Aw-) R X-VC4. COUNTY OF TNa3-Afu eZvEf—
The forgoing instrument was acknowledged be a The forgoing instrument was acknowledged bef a me
this 10 day of M" 20 2-1 b this f0 day of mj 20 .11 by
Name of person making statement. _ o Name of person making statement.
N J Q
Personally Known ✓ OR Produced Identif' al( r Personally Known l/ OR Produced Identifi IN
Type of Identification a jr t isE a Type of Identification aIX
Produced 0 Produced _
\ / Z 12'D
(Signatu a of Notary Public-State of Florida) oo� (Signature o Notary Public-State of Florida)
Commission No. (Seal) Commission No. 6G9Sfi`7cJP (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
NOTICE OF COMMENCEMENT
TO BE COMPLETED WHEN CONSTRUCTION VALUE EXCEEDS$2,500.00 OR
WHEN HEATING OR AIR CONDITIONING REPAIR OR REPLACEMENT EXCEEDS$7,500.00
Permit M Tax Folio#: 2405-601-0396-000-6
State of Florida,County of Indian River, The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter
713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Legal description of the property(and complete street address if available):
Sunland Gardens Blk 22 W 1/2 of Lot 6 and All Lot 7(0.28 AC)-OR 662-1362)
2. General description of improvement:
A/C Change out
3. 0Owner information or 0Lessee information(if the Lessee contracted far the improvement):
a. Name: Edith W.Singleton
b. Address: 3603 Avenue O Fort Pierce FL 34947
. (street address) (complete city name) (state) (zip code)
c. Interest in property: Owner
d. Name&complete address of fee simple titleholder(if different from Owner listed above):
N/A
4. Contractor:
a. Name: DAVID HEATING&AIR CONDITIONING, INC.
b. Address: 116 North Lime Street Fellsmere FL 32948
(street address) (complete city name) (state) (zip.code)
c. Phone number: (772)713-9997
5. Surety Company(if applicable,a copy of the payment bond is attached):
a. Name&complete street address: N/A
b. Phone number: Bond amount:
;aO'ntAE
m;0ran
6.. Lender/Mortgage Company:
i'lli
a. Name&complete street address: N/A °o Z U +
D;&Cr
b. Lender's phone number:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as P
w rn n 3
Section 713.13(1)(a)7., Florida Statutes:St Lucie Count BOCC/2300 Virginia Avenue, Fort Pierce, FL 34982 c n o z in
r-
a. Name&complete street address: Y g m?
b. Phone number: (772)462-1777 Fax number: (772)462-2855 N o
4 m
8. In.addition to himself or herself,a. Owner designates St Lucie County Community ServicEp of 437 N.7th Street,Fort Pierce, FL 34950 o
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. o o
b. Phone number: (772)462-1777 g m
9. Expiration date of notice of commencement:
(the expiration date will be 1 year from the date of recording unless a different date is specified). Z S
0 =i
I'. WARNING TO OWNER: n
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PI
FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND PC
BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
COMMENCEMENT.
(Signature of Owner or Lessee,or Owner's or L see's Authorized Officer/Director/Partner/Manager) (Signatory's Titie/Offce)
The foregoing instrument was acknowledged before me this o4 day of 20 2 tt
By: (printed name of person signing above)
��si>k Ss�J6L�rUtil
As: ow NC.A, For
(type of authority,e.g.officer,trustee,attorney in fact) (name of party on behalf of whom instrument was executed)
ersonally Known OR C)Produced Identification Type of Identification Produced
1 Notary Seal
Notary Sign ure �.1► N% Notary Public State of Florida
Hilda R De La Hoz
My Commission GG 957948
Expires 02/2012024
Notary Printed Name qaR