HomeMy WebLinkAboutMoore Permit App CC_20210916_154330All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9.15.2021 Permit Number:
LL, L L:� - ..
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: Jessica & Nathanael Moore
PROPOSED IMPROVEMENT LOCATION: 1010 Flood Rd Fort Pierce FL
Address: 1010 Flood Rd Fort Pierce FL
Property Tax ID #: 3404-501.0516.000.7 Lot No.
Site Plan Name: Block No.
Project Name: Moore-1010
DETAILED DESCRIPTION OF WORK:
Install 3-ton 16 seer 10kw Rheem complete system
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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 _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5475.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name S C (0
Name: LUKE WALKER
Address:AL M T ` mk
Company: TREASURE COAST AIR
i City: { rp t' C State: EL
Address: 1055 S.W. MARTIN DOWNS BLVD
Zip Code: �AE[ � Fax:
STUART
City: State: FL
? n
• Phone No.�1 a 1 a 9 *
Zip Code: 34990 Fax: 772-288-7046
E-Mail:
Phone No 772-692-1701
Fill in fee simple Title Holder on next page ( if different
E-Mail TCAC 1 990@ATT. NET/TCACSVC@ATT. NET
from the Owner listed above)
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
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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 rec�ur Notice of Commencement.
signature of nenl Lessee/Contractor as Agent for Owner
STATE OF FLORIDA ,.� A��
COUNTY OF /2/
Swor to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this L day of�202,Wlby
Name of person makin7state ent.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of tary Pu ' -State of Florida
Commission No. �X\\\`( F1 L RIO, �flli
•. Commission No.
't�E 13.•
REVIEWS FRONT iOr�tING •S*JPER�
COUNTER jl&o / 48f3EVIE
DATE
RECEIVED
DATE
COMPLETED
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Signat
STATE OF FLORIDA
COUNTY OF
/License Holder
,1'1,411 ii.1-11
Swor affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 20XIby
Name of person making statement.
Personally Known Produced Produced Identification
Type of Identification -
Produced 11
(Signature of Potary Public- State of Flor,� FAEL R1
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