HomeMy WebLinkAboutROESEMANN RESIDENCE AC PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/24/21 Permit Number:
s5uo Lum -
U ``'� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential xx
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FORUKE FOR LIKE A/C CHANGEOUT
PROPOSED IMPROVEMENT LOCATION:
Address: 11100 LANDS END CHASE, PORT ST LUCIE, FL 34986
Property Tax ID #: 3321-803-0014-000-1 Lot No.
Site Plan Name: Block No.
Project Name: ROESEMANN RESIDENCE
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE A/C CHANGEOUT- 16 SEER LENNOX SPLIT SYSTEM, 5 TON, 9KW HEATER
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ 6,000.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameDIANE ROESEMANN
Name:PHILIP NISA JR
Address:11100 LANDS END CHASE
Company: NISAIR AIR CONDITIONING
City. PORT ST LUCIE State: _
Address:3700 S. US HIGHWAY 1
Zip Code: 34986 Fax:
City: FORT PIERCE State: FL
Phone No.772-466-8115
Zip Code: 34982 Fax:
E-Mail:KRISTIN@NISAIR.COM
Phone N0772-466-8115
Fill in fee simple Title Holder on next page (if different
E-Mail KRISTIN@NISAIR.COM
from the Owner listed above)
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 Appli
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 sander -going 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 Cou nd posted on the jobsite before the first inspection If you intend to obtain financing, consult
with lend r ot an attornev before commencine work or recordiw our Notice of Commencement.
Signature of
STATE OF FLORIDA
COUNTY OFSTLUCIE
as Agent for Owner i Signature of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 24TH day of MAY 12020 by
PHILIP NISA A
Name of person making statement.
Personally Known xx OR Produced identification
(Ilfnature of Notary Public- S I R ISTIN BAITSHM
`'•_ State of Florida -Notary F
Commission No. GG279527 g. ._kS�gIT,mission # GG 27B
imy Commission Expii
February 19, 2023
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE i
RECEIVED
MPLETED
STATE OF FLORIDA
COUNTY OF STLUCIE
Holder
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this 24TH day of MAY 2020 by
PHILIP NISA A
Name of person making statement.
Personally Known xx OR Produced Identification
Type of Identification ,,
ture of Notary Public- Sta
KRISTIN BAITSH
GG278527
qof Florida-Notar
s°
e,•
fission NO. fnmission # GG 2
My Commission Er
PLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW