HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/14/2021 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
PERMIT APPLICATION FOR: Ac Change out
PROPOSED IMPROVEMENT LOCATION:
Address: 140 NE Floresta Dr
Property Tax ID #: 3419-570-0104-000-6
Site Plan Name: River Park- Unit 9- Part C
Project Name. Vincent Cama
DETAILED DESCRIPTION OF WORK:
AC change out 2.5 ton Thermal Zone 14 seer 5 KW
Air Handler-TZHSLPST3017, Condenser-TZALS14302SA
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
(Affidavit required)
Lot No. 6
Block No. 81
Additional work to be performed under this permit— check all that apply:
x Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator — Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ $3000.00 Utilities: _ Sewer _ Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Vincent Cama
Name: Stephan S Buckley
Address: 5494 SE Harbor Ter
Company: Ac All Stars LLC
City: Stuart State: FI
Zip Code: 34997 Fax:
Phone No. 561-367-5657 E-
Mail: Vcama@gmail.com
Address: 21280 Rock Ridge Dr
City: Boca Raton State: FI
Zip Code: 33428 Fax:
Phone No 561-667-0621
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Acallstarspermitting@aol.com
State or County License CAC1817509
V U1 ul wnxruuIon is zDuu or more, a Ktw Kutu 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: _ Not App
Name: _
Address:
City: _
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State
_ Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City: _
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 consu t 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 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 commencinc work or rernrriing vnur NnticP of (-nnnmPnrPmPnt
Signature of Con r or - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF Palm Beach
Sworn to (or affirmed) and subscribed before me of X
Physical Presence or Online Notarization
this 14th day of December 2021 by
Stephan S Buckley
Name of person making statement.
Personally Known X OR Produced Identification
Type o fication Produced
(Signs ure of Notary Public- State of rid
4sy,�s
Marissa C. Gomez
Commission No.' t ) (Seal)
f.,.
Comm #HH031824
!. Exores 13. ?Q24
' t 01' W Thru Am Notary
41111 �a�
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