HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/30/2021 Permit Number: Q100-0111;L
cJ�o l�t�.41`.-7U15
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:
FOR, M._ 9,011EME,NT
„ _>, ..• � �..,.��?". .mom'„'' € s �}• �;"�«aa•,��.,,k, '� ,u� � ��x_����� ,. $�.:.�.ra, �. v„
�a
Address: 12094 NW HARBOUR RIDGE BLVD
Property Tax ID #: 4426-804-0032-000-1
Site Plan Name:
Project Name: 2 SYSTEM AC CHANGE OUT 12094 HARBOUR RIDGE
Lot No.
Block No.
AC CHANGE OUT LIKE FOR LIKE 4 TON 16 SEER R410A 10KW HEAT RUUD SYSTEM (ATTIC LOCATION'
SYSTEM
R410A 5KW HEAT SYSTEM #2 MASTER SUITE (ATTIC LOCATION) ,
New Electrical Meter Second Electrical Meter
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 _Aobf Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5800 4600 Utilities: —Sewer _Septic
Building Height:
P wre, -0d fi - f
OWNER/1E5SEE s raNTRAT�
1,
.,..
Name RICHARD BRENNAN
Name: DAVID SMITH.,
J
Company: ONE CALL AIR CONDITIONING
Address:110 SE RIO CASARANO
City: PORT ST LUCIE FL State:
Address:_968,_W_PROUINCETOWN?LN
_
p 34984
Zip Code: Fax:
y;2RDRT0S ftiL�� l ; i .' FL
Ci - ,; , `° :.` State
Phone No.
Z4p Code:495'3�., !3•^Iii` �+ j_' S '�;':' i'
'Fax:
E-Mail:
PhondiNdI7.72-201`=3885'1t+
Fill in fee simple Title Holder on next page ( if different
E-Mail ON'�CALLCOOLING@GMAIL.COM
State or County License CAC1817403
from the Owner listed above)
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.
n .3 t �" ,�i'IF7 '.a�'fi �° . t +* ',
SUP?I�t,Al_CiNSrt UG�T Ci�w1�vL�1� tAtI�Fit�/IAT1CiN„���
- r n� mow- au tr .far
a
as..- x,. tom,` __i 'y , L."� F71E
n':1nk
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
_
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Applicable
Name:
Name:
_Not
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 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 lerfder or an altornevrbefore commencing work or recording vnur Notice of CnmmPnrPnnPnt
Siknlaffure of Owner/ Lessee/Contractor as Age Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFZ&441' ,
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presp nce Qr Online N tarization
Physical Presence or Online Notarization
this day of 202� by
this _ day of 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificatio
Type of Identification
Produch
Produced
(Si ture of Notary Public- Ate of Florida)
(Signature of Notary Public- State of Florida )
Commission No. 11
Commission No. (Seal)
REVIEWS
'
MWIS
PLANS
VEGETATION
SEA TURTLE
MANGROVE
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.