HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/27/2021 Permit Number:
c�^^ LUQ
c c a `_.� `zf 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: Powell-8650
PROPOSED IMPROVEMENT LOCATION:
Address: 8650 S Ocean Drive #1102 Jensen Beach 34957
Property Tax ID #: 3534-501-0050-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Powell-8650
DETAILED DESCRIPTION OF WORK:
Install new Carrier 3.5 ton 14 seer 101<w 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
Sprinklers Generator Roof Pitch
_Electric —Plumbing — Sp —
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
r �
J�� �1 Utilities: _Septic Building Height:
_Sewer
Cost of Construction: $
CONTRACTOR:
OWNER/LESSEE:
i ivc WWI VP:P
Name Stephen Powell
Address: 8650 S Ocean Drive 1102
City: Jensen Beach State:
Zip Code: 34957 Fax:
Phone No. 304-216-6070
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
I14d111C. -- -- -
Company: TREASURE COAST AIR
Address: 1055 S.W. MARTIN DOWNS BLVD
City:
STUART State: FL
Zip Code: 34990 Fax: 772-288-7046
Phone No 772-692-1701
E-Mail TCAC1990@ATT.NET/TCACSVC@ATT.NET
State or County License
CAC058476
If value of construction is 2500 or more, a RECORDED Notice of commencement is required.
If „nlla of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
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 leftder\or an attornev before commencing work or recordigf,) uG Notice of Commencement.
Sign ure of 0 er/ ssee/Contractor as Agent for Owner Signa ure of C rac r i nse Holder
STA F FLORIDA M STATE OF FLORIDA
COUNTY OF / //} � _ COUNTY OF
Swo n to (or affirmed) and subscribed before me of Swto (or affirmed) and subscribed before me of
grp
Physical Presence or Online Notarization Physical Presence or Online Notarization
this 3 day of ff ,E��ish /�/%/I . 207�d/ by this � day of l>�G/� if E/1 202�'�6Y
Name of person making statement. Name of person making statement.
Personally Known
i� OR Produced Identification _
Type of Identification
���FAEL R1SC�
Produced
GI/1� `\ ������O2E1o�
.� J 0 •P•
(Signature Nofar P
lic- State ,gicla )
_i: _
Commission No.
H 004859
o 'a �y
9 ••.ya°nded t��Oyi�°••�
��JA'. °b/ic Under •' C
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE —
COMPLETED
REVIEW
_ Personally Known >-:f OR Produced Idei
Type of Identificatio
Produced
(Signa a of Notary Public- State Florida
Commission No.
O�
OR PLANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW
zEla,�.
�J E 0�9 F '.
#HH 004859
poblic u r%W _c F
MAMCR0
REVIEW