HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: 6/17/2021 Permit Number: 1® 70
RECEIVED
Building Permit Application'JUN 17 2021
NORM
Planning and Development Services St.Lucie County
Building and Code Regulation Division Permittino
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 207 Southland Dr,Apt 1 Fort Pierce, FL 34982
Property Tax ID#: 2427-801-0107-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Replacement of a 2 ton split system with 7 kW heat; like for like; 14 SEER ,
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check,all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric -Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 3574 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name SAMANNA PROPERTIES LLC Name:James J Wauters
Address:29 Old Dock Rd Company:Just Chillin'HVAC LLC
City: Yaphank, NY State:_ Address:5422 NW Cromey St
Zip Code: 11980 Fax: City: Port St. Lucie State:FL
Phone No.772-340-4622 Zip Code: 349.86 Fax:
E-Mail: Phone No 772-940-4373
Fill in.fee simple Title Holder on next page(if different E-Mail justchillinair@hotmail.com
from the Owner listed above) State or County License CAC1819351
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: =Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE BOLDER: _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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sigi4ature of Ow r/Lessee ontractor s Agent for Owner Sj=nature of ntractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF `�'�(�,�C� COUNTY OF
The for oing instr ent was acknowled edllbefore me The forgoing instr ment was acknowledge before me
this day of 200 \by this_M day of 20 by
Name of person making statement. / Name of person making statement.
Personally Known OR Produced Identification " Personally Known OR Produced Identification
Type of Identifigatten Type of Identificati
Produced ' Produced
(Signature-of Notary Public-State of Florida I (Signature of Notary Public-State of Florida)
��,���,,, KaR�( k. NIELSEN
Commission No. o��Y°be°- race of wwtt a Notary Public Commission N
Comrrission.# GG 207484 �lpyyp�I KAREN S. NIELSEN
:� a= s �O State of Florida-Notary Public
June 2, 2022 _'� *= Commission # GG 07484
REVIEWS FR PLANS V �� �S�l�"�0 L`"02 RrM OVE
COUNTER REVIEW REVIEW REVIEW W
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7