HomeMy WebLinkAboutJason - Campbell (2)AI! APPLICABTE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0110612022 Permit Number:
Building Permit Application
Plonning and Development Services
Building ond Code Regulation Division
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-L553 Fax: (772) 462-1578
Commercial Residential X
CBDG Funding
PERM IT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION :
Address: 510 barb ann lane Porl st lucie. FL 34952
Property Tax lD #: Lot No
Site Plan Name:Block No.
Project Name:tuC Change out
DETAILED DESCRIPTION OF WORK:
14 seer 10 kw ooodman oackaoe unit instalation
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping
_ Sprinklers
_ Shutters _ Windows/Doors
-
Pond
_ Generator
-
Roof
-
Pitch_ Electric _ Plumbing
Total Sq. Ft of Construction: _Sq. Ft. of First Floor:
Cost of Construction,s 976 ' Oo Utilities: _ Sewer _ Septic Building Height:
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is reguired.
lf value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
OWNER/LESSEE:CONTRACTOR:
Name Flnyrl Ringhi
Address: 510 Barb ANN Lane
City:Port Saint Lucie State: FL
Zip Code: 34952 Fax:
Phone No. 4192398857 _ E-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Jason CAryPbell
ComPanY: Camphell Cooling I I C
Address: 5484 Nw Empress Circle
City: pn* qrint I r.i.;o State: trt
Zip Code: 34983 Fax:
phone No 7723231567
E-Mail carypqelboolingandhe
State orCounty U6sn5s CAC1820830
LLI,CLLT
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
Address:
City:
7ip:.
State:
Phone
MORTGAGE COMPANY: X Not ApPIiCAbIC
Name:
Address:
City:
zip:
State:
Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Add
City
zip:
ress:
Phone:
BONDING COMPANY:
Name:
_Not Applicable
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 Countv makes no reDresentation that is srantins a oermit will authorize the oermit holder to build the subiect structure
which conflicts with anv aoolicable Homeownershssocia-tioh rules. bvlaws or and covenants that mav restrict or prilhibit such
structure. Please consult with your Homeowners Association and ieview your deed for any restrictions which may apply.
ln 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 fosted on the jobsite before the first inspection. lf you intend to obtain financing, consult
with lender br an bttorney,before commencing work or rei:ording your Notice of Commencement-
of Contra6tor - or - Owner Builder as applicable
STATE OF FLORIDA./ r
couNw oF .Y LA LC/-
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