HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
S 'E CLLLL
.�
,a
L L c � L L) Lk Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Batiwalla , Derick
PROPOSED IMPROVEMENT LOCATION:
Address: 9500 S Ocean Drive 1702
Property Tax ID #: 4502.602.0156.000.9
Site Plan Name: Batiwalla-9500
X
Lot No._
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Install new 2.5 ton 13.4 eer water source heat pump , Climate Master unit system
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
XVlechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Llectric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4880 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Derick Batiwalla
Name: LUKE WALKER
Address: 9500 S Ocean Dr 1702
Company: TREASURE COAST AIR
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No. 9547372929
Address: 1055 S.W. MARTIN DOWNS BLVD
City: STUART State: FL
Zip Code: 34990 Fax: 772-288-7046
Phone No 772-692-1701
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail TCAC1990@ATT.NET/TCACSVC@ATT.NET
State or County License CAC058476
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: X Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: X 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
such
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit
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 or an attorney before commencing work or recorcligzIbUENstice of Commencement.
i
Signature of Ow er/ Lessee/Contractor as Agent for Owner
Signature of Con for/License Holder
STATE OF FLORIDA
�AlZTi�
STATE OF FLORIDA
A�,4,4'�
COUNTY OF
COUNTY OF /,tl
(or
SworPto affirmed) and subscribed before me of
Swo to ((or affirmed) and subscribed before me of
hysical Presence or Online Notarization
/� Physical Presence or Online Notarization
this 3 day of Au �y5 T 2029�by
this 3 day of /iu,66,5 T 2020/'by
Name of person making statement.
Name of person making statement.
Personally Known V1 OR Produced Identification
Personally Known ' OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
\\\�1111111ttNlll/���
\\� 0%I111flll/ll�
(Signature ota P ic- State of FI a) cp �i,
. a��, ssioN '%
(Signa re of Notary Public- State of Florida,�� co '
M�,�ssior�
Commi Zion No. (S al) -1
Commission No. r (Sew °�,�'FN•
REVIEWS
FRONT
O5 . o�
ZON •-y-'I'�kiI
h
S
PLANS
VEGETATION
'.
SEATURTF vp`
4859
►�R�\ e
COUNTER
REVIL•..ktgl
\
REVIEW
REVIEW
REVIEW
\
DATE
l
/IIt11111N11�\\
/ STATE///1111111111N1�\\',\
RECEIVED
DATE
COMPLETED
Rev. 5