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BUILDING PERMIT APPLICATION
All APPLICABLE INFO MU ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: © ( Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Commercial CC) ca Residential PROPOSED IMPROVEMENT LOCATION: Address: 5120 Property Tax ID #{� �/J� Site Plan Name: Q Project Name: ls�ca �_��(\'o1 \ � DETAILED DESCRIPTION OF WORK: Asa \r f` 1 CA A i 111cu�� New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additi nal work to be performed under this permit -check all that a I pp Y: gMechanical _ Gas Tank _ Gas Piping Shutters _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ I Ll A 19 O Generator I Lot No. Block No. �-1 (Affidavit required) Sq. Ft. of First Floor: Windows/Doors Pond — Roof Pitch Utilities: —Sewer —Septic OWNER/LESSEE: I CONTRACTOR: Name t. Address: City: f-+ . �j �(� State: Zip Code: Cj l- Q R- 4L Fax: Phone No. - t-{) - E-Mail:'�0'rn',Pd1 1 �-WOcV-'SAO . ('nm Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Building Height: Company:2'1. ,EA&rf6e rtned a; � Address: i (o (Ce 6 (V City: C - . W ' -e— \ State: .___. e: R Zip Code: 3401 p (% Fax �a�l `40 ;W0o) Phone No /a E-Mail_ F'e,(m,I- Jd PPl State or County License (`ftC11 9-1 (e 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: City: State: Zip: Phone 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 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 attorney before commencing work or recording your Notice of Commencement. I Signature of Qfi+r/ Lessee/Contractor as Agent for Owner STATE OFI COUNTY O Sworn to (or affirmed) and subscribed before me of , °Physical Presence or Online Notarization this 10 day of 19:E, L)j•t , 2QJJ by Name of person making statement. Persgpal_4 -Known OR Produced Identification type of Identification oduced (Signature of Notary Public- State of Florida ) Commission No. d1l t (Seal) REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Ko,"4 :Naljonal AE DEWITT i Notary PubState of Florida %N ; 5lmyf CommissGG 166915 v�r My Comm. Es Dec 10, 2021 Bonded througNolaryAssn. SUPERVISOR I PLANS I VEGETATION I SEA TURTLE I MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW r�ai,21 CERTIFIED' www.ahridirectory.org Ah Lef;1rro a This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between 1/1/2015 and 12/31/2020. AHRI Certified Reference Number: 8864541 Date : 06-24-2020 Model Status : Active AHRI Type: RCU-A-CB Series: LX SERIES Outdoor Unit Brand Name : YORK Outdoor Unit Model Number (Condenser or Single Package) : YCG421321 Indoor Unit Model Number (Evaporator and/or Air Handler) : AE42CX21+TXV Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, INC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, WY, U.S. Territories) Region Note : Central air conditioners manufactured prior to January 1, 2015 are eligible to be installed in all regions until June 30, 2016. Beginning July 1, 2016 central air conditioners can only be installed in region(s) for which they meet the regional efficiency requirement. The manufacturer of this YORK product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2, Performance Rating of Unitary Air -Conditioning & Air -Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored, independent, third party testing: Cooling Capacity (A2) - Single or High Stage (95F), btuh : 41500 SEER: 17.00 EER (A2) - Single or High Stage (95F) : 13.75 t"Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale; OR new models that are being marketed but are not yet being Produced ."Production Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratings that are accompanied by WAS indicate an involuntary re -rate The new published rating is shown along with the previous (i.e. WASI rating. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at wwwaahridimctory.arg. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; �■- entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, Milli personal and confidential reference. AIR-CONDITIONING. HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www,atirldirectory.org, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, ,e make life betier'" which is listed above, and the Certificate No., which is listed at bottom right. ©2020Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.- 132374976278316495 Michelle Franklin, CFA -- Saint Lucie County Property Appraiser -- All rights reserved. Property Identification Site Address: 5100 Parcel ID: 3402-602-0164- Account #: 36548 Sec/Town/Range: 02/36S/40E PINETREE DR 000-8 Map ID: 34/02S Zoning: RS-3 - Con Use Type: 0100 Jurisdiction: Saint Lucie County Ownership Legal Description Thomas A Mosley INDIAN RIVER ESTATES -UNIT 1- BLK5 LOTS 1 AND 2 5100 Pinetree DR (MAP 34/02S) (OR 470-1044: 933-1931: 1003-1429: 1009-1107: Fort Pierce, FL 34982-7479 3920-1383) Current Values Historical Values 3-year Just/Market: $179,100 Assessed: $89,788 Year Just/Market Assessed Exemptions Taxable Exemptions: $50,000 Taxable: $39,788 2020 $179,100 $89,788 $50,000 $39,788 2019 $174,700 $87,770 $50,000 $37,770 2018 $169,200 $86,134 $50,000 $36,134 Sale History Date Book/Page Sale Code Deed Grantor Price 08-11-2016 12-09-1994 3920 / 1383 0933 / 1931 0130 WD Mosley Jimmy L XX01 QC Mosley $31 300 Jimmy L $100 Primary Building Information Finished Area of this building: 1,900 SF Gross Sketched Area: 3,128 SF View: Roof Cover: Dim Shingle Year Built: 1984 Frame: Primary Wall: Wood/Sheath Story Height: 1 Story Bedrooms: 3 Full Baths: 2 Half Baths: 0 A/C %: 100% Heated %: 100% Sprinkled %: N/A% Exterior Data Roof Structure: Hip Building Type: HC Grade: C Effective Year: 1984 No. Units: 1 Secondary Wall: Interior Data Electric: MAXIMUM Primary Int Wall: Heat Type: FrcdHotAir Avg Hgt/Floor: 0 Heat Fuel: ELEC Primary Floors: Carpet Total Areas Finished/UnderAir 1,900 (SF): Gross Sketched Area 3,128 (SF): Land Size (acres): 0.91 Land Size (SF): 39,600 Total Building Count: 1 Special Features and Yard Items Type Qty Units Year Blt Driv-Concret 1 600 1984 UTILITY AVG 1 140 2000 All infonnation is believed to be correct at this time, but is subject to change and is provided without any warranty. 0 Copyright 2021 Saint Lucie County Property Appraiser. All rights reserved. X. MILLER, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY FILE # 4903718 OR BOOK 4659 PAGE 1689, Recorded 08/04/2021 09:48:03 AM Doc Tax: $1925.00 Prepared by and return to: James P. McHugh, Esq. .James P. McHugh, LLC 1555 Indian River Blvd., Suite 125 Vero Beach, FL 32960 (772)226-7400 File Number: 21-042 Parcel Identification No. 3402-602-0164-000-8 Above This Line For Recording Warranty Deed (STATUTORY FORM - SECTION 689.02, F.S.) This Indenture made this 2nd day of August, 2021 between Thomas A. Mosley, a single man whose post office address is 5100 Pinetree Drive, Fort Pierce, FL 34982 of the County of St. Lucie, State of Florida, grantor, and Damien Agostinelli and Janice Marks, husband and wife, whose post office address is 3219 7th Street NE, Washington, DC 20017 of the County of District of Columbia, State of District of Columbia, grantee, Witnesseth that said grantor, for and in consideration of the sum of TEN AND NO/100 DOLLARS ($10.00) and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land, situate, lying and being in St. Lucie County, Florida, to -wit: Lots 1 and 2, Block 5, INDIAN RIVER ESTATES - UNIT ONE, according to the Plat thereof, as recorded in Plat Book 10, Page 43, Public Records of St. Lucie County, Florida. Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. Subject to taxes for 2021 and subsequent years, not yet due and payable; covenants, restrictions, easements, reservations and limitations of record, if any. TO HAVE AND TO HOLD the same in fee simple forever. And Grantor hereby covenants with the Grantee that the Grantor is lawfully seized of said land in fee simple, that Grantor has good right and lawful authority to sell and convey said land and that the Grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever. File Number: 21-042 VX rs(JUtt 46b9 PAGE 1690 In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above written. Signed, sealed and delivered in our presence: Witness Desiree Chadwell Printed Name: Witness JaMeS P. McHugh Printed Name: STATE OF FLORIDA COUNTY OF INDIAN RIVER 1 _ Thomas A. Mosley The foregoing instrument was acknowledged before me by means ofKphysical presence or L] online notarization, this 301h day of JuIy, 2021 by Thomas A. Mosley who L] is personally known otKhas produced a driver's license as identification. JAMESMCHUGH °PYP ¢State of Florida -Notary Public [Seal] `'ommission If GG 175369 =` My Commission Expires Not none January 24, 2022 File Number: 21-042 Warranty Deed (Statutory Form) — Page 2