HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/28/2021 Permit Number:
V. i- U L�L�.tlR .
Building pp Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 1684 CHRISTMAS COVE
Property Tax ID #: 2303-211-0025-000-5
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE 3.5 TON PACKAGE UNIT 14 SEER WITH 10 KW HEATER
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
LMechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:.
Cost of Construction: $ 4755
_ Generator
Sq. Ft. of First Floor:
Residential X
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name LARRY & GLORIA DUROCHER
Name: CURTIS SAMMONS
Address: 1684 CHRISTMAS COVE
Company: CUSTOM AIR SYSTEMS INC
City: FORT PIERCE State: �-
Zip Code: 34945 Fax:
Phone No. 772-359-9201
Address: 1615 SE VILLAGE GREEN DR
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax: 772-335-1968
Phone No 772-335-3232
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail CUSTAIRSYS@AOL.COM
State or County License CAC051810
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.
F1t3tt1:LIEN LAW INFORMAT[atl I
DESIGNER/ENGINEER: Not Applicable I
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address: 'Address:
I
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
f BONDING COMPANY: ^Not Applicable
Name:
Name:
I Address:
Address:
City:
City:
Zip: - Phone:
I
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 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 inspection. If you intend to obtain financing, consult
with lender or an attorneybefore commencing work or recording our Notice of Commencement.
iSignature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
I
COUNTY OF ST C U C6 4c
COUNTY OF 5 `i-` 1_ U r : w
1
i Swgrn to (or affirmed) and subscribed before me of
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Swojn to (or affirmed) and subscribed before me of
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I �/ sical Presence or Online Notarization
this day
✓Physical Presence or _ ._Online Notarization
i of _� c�c , 2020 by
this ZS day of 203 by
Cvr
Name of person making statement.
Name of person making statement.
Personally Known Y_ OR Produced Identification
I
Personally Known VOR Produced Identification
Type of Identification
Type of Identification
i
Produced
Produced
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(Signature of N4dtary Pu c- State of Florida)
'*aY1ts CHRISTINE 6. E
(Signature of Notary Pub '- State of FI a )
ISH t► CHRISTINE B.
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Commission No.i1fi D 6 fed % ; u Comersll *HH06
Expires April 4, 20
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REVIEWS
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PLANS VEGETATION
SEA TURTLE
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REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
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COMPLETED
Rev.
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Custom Air Systems
'Proposal and 4weement
Address
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We +i1l furnish, install antir;ry e, the vgUipment littc d htqow at The privu, ;crms and conditions outfined on this proposal.
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