HomeMy WebLinkAboutGRIFFIN 10072 PERMIT APP._20220318All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: MARCH 17 2022 Permit Number:
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 CBDG Funding
PERMIT APPLICATION FOR: HVAC REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:
Q
Address: 10072 S. OCEAN DRIVE SOUTH #5 JENSEN BEACH
Property Tax ID #: 4502-805-0008-000-0 Lot No._
Site Plan Name: GRIFFIN-10072 Block No.
Project Name: GRIFFIN -10072
DETAILED DESCRIPTION OF WORK:
INSTALL 3 TON 16 SEER 10KW RHEEM SYSTEM
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
XMechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: 3069
Cost of Construction: $ 5850.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name PATTI GRIFFIN
Name: Luke Walker
Address: 10072 S OCEAN DRIVE SOUTH #5
Company: TREASURE COAST AIR
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
Phone No. 578-339-6994 E-
Address: 1055 S.W. MARTIN DOWNS BLVD
City: Palm City State:
Zip Code: 34990 Fax:
Phone No 772 692 1701
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-mail TCAC1990@ATT.NET
State or County License CAC058476
It value of construction is Z500 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, 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 a_UGMev before commencing work or recording our Notice of Commencement.
Signature - wrier ilder as applicable
STATE OF FLORIDA
COUNTY OF 0_1 lr
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this day of 20_ by
.r.cl1y
Name of person making statement.
Personally Known _�—' OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
Commission No. ;� Cj { (�
(Seal) ::''�" NICOLE LYNN NELSON
MYCOMMWION#HH187930
'>, d EXPIRES: November 19, 2025
Bonded Thru Notmy Public Underwriters
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