HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONWI.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .
Date:.8/81/2021' Permit Number:
• gECENED
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-_ ---- Building Permit Applicati
Planning and Development Services _
Building and Code Regulation Division St. Lucie County
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2300 Virginia Avenue, Fort -Pierce FL 34982
Phone:-(772) 462-1553 -Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE: J :f- --
PROPOSED IMPROVEMENT LOCATION:
1752,Golden, n`Dr, Fort.Pierc, FL 3494'5 . I
Address: Pod 'e "
- "
Property Tax II) #: 2303-211-0025-000-5.,
Lot NO.
Site Plan Name:
Project Name: -
Block No.
DETAILED, DESCRIPTION OF WORK:
Replacement of a 3-1/2 4on,packaged system with.10 kW heat; like.for like; 14.SEER
[CONSTRUCTION INFORMATION:
Additional work,.to be, performed under this permit —check all that apply:
_Mechanical - = Gas Tank _ Gas Piping —Shutters Windows/Doors
--Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
3900
Cost of Construction: $ Utilities:- —Sewer _ Septic Building-"ight:
OWNER/LESSEE:
CONTRACTOR
If value of construction is $2500 or more, a RECORDED Notice of Commencement'is required.
If value of HVAC is $7,500 or more, a RECORDED'Notice of Commencement is required.
`SUPPLEMENTAL=CONSTRUCTION"L(ENLAW�(NFORNIA�TLON� 1z` �P4}`
DESIGNER/ENGINEER:_
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: I'.
State`
Zip: Phone
Zip: Phone: I
^
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 acid coveriarits that may restrict or prohibit such
structure. Please -consult with your Home Owners Associatiori and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that.l 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 addition's,
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 JOB SITE BEFORE THE FIRST; INSPECTION., IF YOU INTEND •TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR -AN ATTORNEY BEFORE -RECORDING YOUR NOTICE'OF COMMENCEMENT."
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Sig ture of Owr(er/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA (5�_
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 2Q'� by
this day of , 20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
0
(Sig _ ,Qtery Pp f Florida)
(Signature of Notary Public- State of.Florida, )
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Co i `: �Ofi °f �° as /�V �'H11�{Se
—"y C0 7 -Zary
Commission No. (Seal)
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Oct o miss,OnG 270� bli°
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2 p22' es
REVIEWS
FRONT
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIE
REVIEW -
REVIEW
REVIEW.
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. Z/ // 19