HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST 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 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 6799 DICKENSON TERRACE
Legal Description: OLEANDER PINES REPLAT BLK 1 LOT 133 (0.226 AC)
Property Tax ID #: 3415-706-0004-000-8 Lot No.133
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
ETAtLE ) DESCRIPTION OF WORK:
Replace Existing Heat Pump with Thermeau TH-125 COP 80, 80, 80 COP 5.5
80, 80, 63 COP 5.3
50, 80, 63 COP 4.0
CONSTRUCTION INFORMATION:
Additional work to a er orme un er t is permit-chec`a 11 apply:
0HVAC �GasTank E]GasPiping _Shutters ❑Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 2200 Utilities :�Sewer E]Septic Building Height:
Name DENNIS & CAROL BACHMAN Name:
Address: 6799 DICKENSON TERRACE Company: Morningside Pools
City: PORT ST LUCIE State: FL Address: 1768 SE Port St Lucie Blvd
Zip Code: 34952 Fax: City: Port St Lucie State: FL
Phone No.908-910-4120 Zip Code: 34952 Fax: 772-337-2737
E-Mail: dbcbl3gaol.com Phone No. 772-337-7151
Fill in fee simple Title Holder on nextpage (if different E-Mail: morningsidepools@bellsouth.net
from the Owner listed above) State or County License: CPC-1456784
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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AL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name: DENNIS & CAROL BACHMAN
Add resS: 6799 DICKENSON TERRACE
City: PORrSTLUCIE State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address: 1768 SE Pon St Lucie Bmd
Zip:
MORTGAGE COMPANY:
Name:
Address; 6799 DICKENSON TERRACE
City: PortSt Wcie
Zip: Phone:_
Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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 vour Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFstwce
COUNTY OFstL-ie
The forgoing instt was acknowledged before me
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this day
The forgoing instrument was cknowledged before me
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Name of p ersor),makin statement
Name of person aking statement
Personally Knownt/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17