HomeMy WebLinkAboutGreen - Johnson, J - SLC Permit App NotorizedAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
S r� LUCEL
O'DILL,,l�:iir'i' =
L7 L C- u, a L' k ` Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 8 Rio Verde Way Port St. Lucie, FL 34952
Property Tax ID #: 3426-500-1252-000-0 Lot No. 8
"LI61EGARDENS26X40 THAT PART OF ELKS I AM2LYG ELY OF I15.1 AS SHOWNW OR Z3 720BEING LOTS RIOVEFUE WAY10.11 ACIIOR JSfO-15fi21
Site Plan Name: Block No.
Project Name: Green Like for Like a/c change out
I DETAILED DESCRIPTION OF WORK: I
Like for like a/c change out with no duct work using: rI IIIuE IVICIII JCIICJ C.J I VI I Jplll JYMCIII Iv JCOI wnn tea.
9 g• r'nndanc'L g I In'r
Model# ML14XCl-030-230
AHRI# 202540542 Air Handler Unit
o e
New Electrical Meter Second Electrical
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
X Mechanical
Electric
_Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4,995.00
_Gas Piping
_ Sprinklers
Shutters —Windows/Doors _ Pond
_ Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Joan K Johnson
Name: ROBERT CAMPBELL
Address:8 Rio Verde Way
Company: Breathe Healthier Enterprises Inc
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
Phone No. (772) 380-2107
Address:7886 SE ELLIPSE WAY
City: Stuart State: FL
Zip Code: 34997 Fax:
Phone No 772-600-7151
E-Mail: unknown
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail SUPPORTOBREATHEHEALTHIERAIR.COM
State or County License CAC058685
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
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: . x Not Applicable
BONDING COMPANY: x 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 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 attornev before commencine work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
.5/
STATE OF FLORIDA
COUNTY OF _ Q-I
COUNTY OFF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
X Physical Presence or Online Notarization
this 29th day of November . 2020 by
this 29th day of November . 2020 by
Joan K Johnson
ROBERT CAMPBELL
Name of person making st ment.
Name of person making stat nt.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identific io
Type of Identificatj n
Produced
Produced
(Signat Ndtary *R,tu
(Signaotary
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Comm n
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Cmm�.: HH 12�
17
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l 11Y2, 2025
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/20