HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/30/2021 Permit Number:
O J'
t; z _�
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR:AC Changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 9600 S Ocean Dr, 4, Jensen Beach, FL 34957(lint 64P-
Property Tax ID #: 4502-620-0013-000-1
Lot No.
Site Plan Name: n/a Block No.
Project Name: n/a
DETAILED DESCRIPTION OF WORK:
Like for like AC Changeout. Installing 2.5 Ton- TRANE unit. With 8KW 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
Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 2,500.00
Windows/Doors Pond
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Karen Segalla
Name: Kim Wilson
Address: 9600 S Ocean Drive, Unit 702
Company: Premier Plumbing and Air
City: Jensen Beach, FL State: _
Zip Code: 34957 Fax:
Phone No.305-799-3723
Address: 108 NE Dixie Hwy
Stuart
City: State: FL
Zip Code: 34994 Fax: 772-692-1094
Phone N0772-692-2500
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If unlnn of rnnc+a..Fi.... i, -jrnn
E-Mail preplbgac@gmail.com
State or County License CAC-033574
- -- --- ---- -- ---- -. ...�-•�-r wuuv u %,ulilnmncement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
•z�. c.s er {{�r.R: —Not Rppfi� ble
Name:
Address,
City: State;
` Zip: Phone
,j SEE SIMPLE TITLE HOLDER: Not Applicable
tame:
Andress:
(l City:
1 Zip: Phone:
MORTGAGE COMPANY: Not Applicable Rr
Name:
Address:
City: State. -
Zip:
Phone:
OcrnuIM CWPANY: Not Applicable --
Name:
Address.'
City:
Zip: Phone: -- - -
OWNER/ CONTRACTOR AFRDVIT. i talon is. hereby made to obtain a Permit to do the work and installation as indicatej,
!,certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representatian that is permit will a
g a peuthorize the permit holder to build the subject structure
which is in conflict y4th arty applicable Nerve Owners Assoc>at�urt rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult wrttr your Home Owners Association and review, your deed for any restrictions which may apply.
onsideration of the granting of this reque$ted permit, I do hereby agree that i will, in all respects,
perform the work
in accordance with the approved plans, the Ftorisda Building Codes and St. Lucie County Amendments.The following building permit applications are.exempt from undergoing a full concurrency review: room additions,
accessory structures, switr MRg pis, fermi VOHS, sigm, screen rooms and accesswy.2 uses to another non-residential use
"WARJMG TO OWMK YOUR FAflAM TO RIECOM A NOME OF
T!'4CE FOR nfT� T{Q Yl1EA! MAY RESULT N YOUR PAYING
POSTED ON TIE .IOE Siff Y. A NBTKE t* NM BE RECORDED AND
Bl TI flRST N WSCTWX w yOU MITEW TO OffTAMi FW ANCING, CONSULT
1rOtlR: LY OR AN ATWMMY BROW RECORDW YOUR N07KX OF
L. 1'J 4Lt_g�v�
Signature of owner/ Lessee/Contractor as Atgeirt` for der
STATE OF FLORIDA
COUNTY OF :C
The fo ing instrume t was nowledged before me.
this -Clay of a 20.'7/ by
Name of Person making statement.
Personally Known ✓ OR Produced ldentificabon
Type of Identification
Produced
is Ig —nat u- r4 of Notary ic- Sta£e of }
Goodmosomw
REVIEWS
I w-VUN r CK KWIEW i REVIEW
TE
Signature of Contractor ice }colder
STATE OF FLORIDA /
COUNTY OF , _7 . /_Cl
The f rng instru wa acknowledged efore me
this ,�dayof a, 20Ja by
l I , I(�' oy�
Name of person making statement,
Personally Known ' OR Produced identification
Type of Identification --
Produced
t�►.Sere I Public- State of Floridi,.I
CommissionMIGROVE
al)PLANS
REVIEW REVIEW REVIEW j REVIEW