HomeMy WebLinkAbout20211124101911.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
IS- L U'c-'---"m
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 9417 Scarborough Ct
Property Tax ID #: 3322-507-0031-000-0
Site Plan Name:
Project Name: Poonam Chaube
A/C Change Out Carrier 2Ton 16Seer 5KW 24ACB724 /FV4CNF002L
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 5664.00
Name Poonam Chaube
_ Generator
Residential XXX
Lot No. 26
Block No.
— Windows/Doors _ Pond
Sq. Ft. of First Floor:
_ Roof Pitch
Utilities: —Sewer _Septic Building Height:
Address: 9417 Scarborough Ct
City: Port St Lucie State: _
Zip Code: 34986 Fax:
Phone No. 772-595-5879
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Jeffrey Lindstrom
Company: Lindstrom Air Conditioning
Address:3581 W McNabd Rd
City: Pompono Beach State: FI
Zip Code: 34986 Fax:
Phone N0772-600-4088
E-Mail
State or County LicenseCAC0569712
it value of construction is Z500 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.
S0fP0,LE1M?ENTAL CONSTRUCTION
LIEN LAW
IN 012MATION
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure, Please consult with your Homeowners 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 ures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARN' G T OWNER: our failure to Record a Notice of Commencement may result in paying twice for
im rove ents toy ur'property. A Notice of Commencement must be recorded in the public records of St.
L ie Co my �hd shed on the jobsite before the first inspection. If you intend to obtain financing, consult
Ith len er a t rnev`b are commencini= work or recordina vour Notice of Commencement.
a"Ay Poe,, DULCE MARTINEZ
e `� ���` "
a Lessee/Contractor as Agent for Owner
Si ofZORIDA
Commission # HH 119702
Expires May 10, 2025
N„9r
ST E OF
\o�
FOF" Bonded ThruBudget Not" Services
C NTY OF
Swor to (or affirmed) and subs rib befor# me of Yof
Physical Presence or Online Notarization
this ay of D 20A by
N me of person making statement.
Personally Known X,,�CX OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
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