HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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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-IS78
Commercial
CBDG Funding
PERMIT APPLICATION FOR: HVAC
PROPOSED IMPROVEMENT LOCATION:
Address: 8024 Meadowlark Ln Port St. Lucie, FL 34952
Property Tax ID #: 3425-706-0051-000-3
Site Plan Name: THE PRESERVE AT SAVANNA CLUB- BLK45 LOT 39(OR 3123-870)
Project Name: Girafalco like for like a/c change out
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
X Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ rinon no
Residential X
(Affidavit required)
Generator
Lot No. 39
Block No. 45
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Girafalco, Ralph
Name: ROBERT CAMPBELL
Address: 8024 Meadowlark Ln
Company: RrPathp Henithitar FntPrprisPs Inc
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
Phone No. (610) 291-0498 E-
Address: 7RR6 PF FI I IPSF WAY
city: Stuart State: FL
Zip Code: 34997 Fax:
Phone No 772-600-7151
Mail: Ralph29@comcast.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-mail SUPPORT@BREATHEHEALTHIERAIR.COM
State or County License
It value of construction is Z5UU 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: 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, 1 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 vour Notice of Commencement.
Signature of Contract r - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF St_ Lucie
Sworn to (or affirmed) and subscribed before me of
_ Physical Presence or Online Notarization
this 21 day of February , 20_2Z by
ROBERT CAMPBELL
Name of person making statement.
Personally KnoVn X OR P duced Identification
Type of (dent' P uc
(Sign ur f N ic- State of Florida)
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MY Comm Expires:
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MBY 2, 2025
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