HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
JYO L1CIJ19
o r
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
PERMITAPPLICATMIN FOR:Ac change out horizontal
PROPOSED IMPROVEMENT LOCATION.
Address: 777 Nettles Blvd Jensen Beach
Property Tax ID #: 4502-501-0963-000-9
Site Plan Name:
Project Name: Karun (Pamela's Pineapple House)
DETAILED DESCRIPTION OF WORK:
AC change out 3 ton 14 seer 10 kw heat
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
(Affidavit required)
Lot No.
Block No.
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5686 Utilities: _ Sewer _ Septic
Roof
Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Pam Karun -
Pamela's Pineapple House LLk.
Name: Paul Cloutier
Address: 18673 Lake
Bend Dr
Company: FPL Home Services
City: Jupiter
Zip Code: 33458
Phone No. 561-543-9192
State: FL
Fax:
Address: 7830 Byron Dr #7
City: Riviera Beach State: FL
Zip Code: 33404 Fax:
Phone No 561-946-6835
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail jennifer.beams@fplhs.com
State or County License CAC1820030
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:
Name.
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address.
City:
Zip:
Phone
State:
City: State.
Zip: Phone.
FEE SIMPLE TITLE
Name:
HOLDER.
_ Not Applicable
BONDING COMPANY: 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 recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF St Lucie
Sworn to or affir d) qnd subscribed before me of X Ph sical Presence or Online Notarization
this 9 day of �epemer , Zo 21 by y
Name of person making statement.
Personally Known
Type of Id tifi i
X OR Produced Identification
ivo[Ny rupNC StaN O(fi0tid�
(Signature of No ary Public- State of Florida) �r f Jennifer V Beams
a n 023214
Commission No. (Seal) arse 07/23/2024 _ _ _
REVIEWS
RECEIVED
DATE
COMPLETED
FRONT ZONING
COUNTER REVIEW
SUPERVISOR I PLANS
REVIEW REVIEW
VEGETATION SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW