HomeMy WebLinkAboutBuilding Permit Application (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
� r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mech App
PROPOSED IMPROVEMENT LOCATION:
Address: 6517 Las Palmas Way Pt St Lucie FL 34952
Property Tax ID #:
Site Plan Name:
Project Name:
15-504-0034-000-7 7
34Lot No.
Miller, Stanley
DETAILED DESCRIPTION OF WORK:
AC change out 3.5 ton 15 seer vertical 8 kw heat
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
_Gas Tank
_Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ \ <<fP
_Gas Piping
_Sprinklers
_Shutters
_Generator
_Windows/Doors
Sq. Ft. of First Floor:
Roof
Block No.
Utilities: _Sewer _Septic Building Height:
Pond
Pitch
OWNER/LESSEE.
CONTRACTOR:
Name Stanley Miller
Name: Paul Cloutier
Address: 6517 Las Palmas Way
_
Company: FPL Home Services
City: Port St Lucie State: FL
Zip Code: 34952 Fax:
Phone No. 772-206-1383
Address: 7830 Bryon Dr #7
City: West Palm Beach State: FL
Zip Code: 33404 Fax:
Phone No 561-946-6835
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail jennifer.beams&fplhs.com
_
State or County License CAC1820030
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 Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
_
Address:
City: State:
Zip: Phone
City: _State:
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 wgrk 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 attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Palm Beach
Sworn to (or affirmed) and subscribed before me of x Physical Presence or Online Notarization
this 1 day of July 2021 by
Name of person making statement.
Per Ily Known x OR Produced Identification
T pe of entification Pr uced
(Signaturt of Nota Public- State of Florida) > `"
4s ovpr Notary Public State of Florida
to Jennifer V Beams
Commission No. (Seal) c My Commission HH 023214
oe° Expires 07/23/2024
REVIEWS
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SUPERVISOR
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DATE
RECEIVED
DATE
COMPLETED
Rev!)/20/21