HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
{{03/31/2022
LJ\ Lo
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
AC Change _out. Like for like 4 Ton Split _
PROPOSED IMPROVEMENT LOCATION:
Address: 8281 Sandpine Circle Port St Lucie 34952
Property Tax ID #: 3426-703-0068-000-9 Lot No. 54
Site Plan Name: Lake Lucy Estates Block No.
Project Name: Cook AC Changeout
DETAILED DESCRIPTION OF WORK
Installation of a Tempstar 4 Ton Verticle Split: like for like AC CHANGE OUT
L!3
EC- 9-, I D K IA4
New Electrical Meter Second Electrical Meter (Affidavit required)
----------
CONSTRU�ClN INFORMATION: ---- ---- -- —
�__ --
Additional work to be performed under this permit — check all that apply:
X,XMechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 6650.00 Utilities: —Sewer _ Septic Building Height:
OWNERAESSE`E:
COMTRAG { R: r
Name:John Browning
Name John and Margaret Cook
Address: 8281 Sandpine Circle
Company: JBAC AND ELECTRICAL INC
City: Port St Lucie State: FI
Zip Code: 34952 Fax:
Address: 2090 NW FEDERAL HWY
City: STUART State: FL
Phone No. 772-344-2920 E-
Zip Code: 34994 Fax:
Mail- macook39@aol.com
Phone No 772-634-6315
Fill in fee simple Title Holder on next page (if different
E-Mail jbackimberly@gmail.com
State or County License CAC1816319
from the Owner listed above)
If value of construction is 2500 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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
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 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
%Ai+h Icnrlcr nr an attnrnpv hpfnrp rnmmPnring wnrk or rerordinE vour Notice of Commencement.
Stature of Con or - or - Owner Builder as applicable
STATE OF FL RIDA ST LUCIE
COUNTY OF
Sworn to (or affirmed) and subscribed before me of _XX
Physical Presence or Online Notarization
this 31 day of MARCH 12099 by
John Browning
Name of person making statement.
Personally Known xx OR Produced Identification
Type of Identification Produced
r
(Signature of N tary Pub 'c tate of Florida)
I(IMBERLY A FERRElL
Commission No. )' 2377(Seal) Notary Public
State of Florida
Commit HH212345
19 Expires 1/2/2026
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21