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HomeMy WebLinkAboutSUBMITTED PAPERSAll APPLICABLE NSO MUST BE COMPLE '!FOR APPLICATION T:O BE ACCEPTED � Date: SCAfVIVED Permit Number: . Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 4624578 PERMIT APPLICATION FOR: Address: Legal Description: BY St: Lucie, County Building Permit Application Commercial Residential f Property Tax ID #: mg46 oy ��© ^�. Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: //lam /Z-r Uhc- .3T^ 13S«r C�A s-e. ovv Block No. ditional work to be pertormed under this permit— cnecK au tnat appry: _Mechanical _ Gas Tank _ Gas Piping. _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Cost of Construction: $ .S L Nam a City: ''1 Zip Code: 0/W.5- Fax: Phone No. 77a� lP�� E-Mail: Sq. Ft. of First Floor: Utilities: —Sewer _Septic State: /fV Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Building Height: Name: eurtl5.: �a lMY►'loil S Coriipariy r,' il's'r�iitr: ,-'t.r S�S�e�ns )AJC. Address: ;'1(e.l"5.; Dr city:poQ.-C ST' ucke_ State:rL. Zip Code: 3425) Fax: qU 335 1 �b Phone No. 772 33,5 -323 2- E-Mail: Cost if- su C V ao ) •acm State or County License: CA C 0 5 1,? !O - S4cLf e ' if value of construction is 25Wor more, a RECORDED Notice of Commencement is required. ___ il'.I'".._.�S!s," i �i,, .{. ,i.. .,�F �� 6� I � 'J,1tt !��!�� � ,..� i��r . i � y�' '\ � j��'y �, • , Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: _ Not Applicable Name: Not Applicable 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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners 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 your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording vour Notice of Commencement. 14 Signature of Owner/ Agent/ Lessee Signature of Contractor/License Holder STATE OF. FLORIDA /� COUNTY OF Y/- STATE OF FLORIDA �LL�G/ ZG&,6 COUNTY OF ey p . The forgoing instrument was acknowledged before me The forgoing instrum nt was acknowledged before me ' this day of 20� by this n day of 20 f /by / Z/�_ � f (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Stat f Florida) (Signature of Notary Pu ic- State Florida ) 'Pub/lic- Personally Known Y OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced p p / / a°`; •••.B�% CHRISTINE & ENGLI Commission No. MY COMMISSION#EE85 EXPIRES: April4, 201 sqT Ho CHRISTINE B. ENGLIS 2E4ommission No. 11. MY COMMISSION # EE 859,, N,y EXPIRES: Bonded 'ces 40 `o� April 4, 2017 ��OP Thru Budget Notary Se FOF F�° Ft�' Bonded'fhr�B aet Not uy Spry, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Kev. //ZU14 J Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL. 3498.2 Phone:(772)462-2172 Fax:(772)462-6443 Inspection Card Permit # : 1409-0009 Online address: http://www.stlucieco.org/planning/permitting.htm Quick Links: Permit Status Lookup Online Building Inspection System Permit# SLC-1409-0009 936 Status ISS #Confirmation MECHANICAL/HVAC RESIDENTIAL - Issued: 9/3/2014 Type: REPLACEMENT SYSTEM Job Location: 8633 Florence Dr City: Port St Lucie Jurisdiction:, ST LUCIE COUNTY Parcel: 3426-664-0093-000/5 Subdivision: LA BUONA VITA MHP Lot: 94 Block: Flood: AE Elev: 9 Flood Map: 29OF Set backs: Left: Right: Front: Rear: Job Description: Changeout Like For Like 3Ton, 13Seer,10Kw System Contractor Curtis A Sammons -- Cert # 9776 Custom Air Systems Inc (772) 335-3232 1615 Se Village Green Dr Port St Lucie, FL 34952 Property Owner Cynthina R Kowalczyk (772) 878-8418 50 Rockland Road . West Brookfield, MA 01585 Property Owner Gerald K Kowalczyk (772) 878-8418 West Brookfield, MA 01585 SUB -PERMITS Permit No Status Permit Type Cert # DBA Owner/Builder For the automated inspection system call (866) 284-1280. To schedule an inspection online go to ` http://codeinspectionpublic.stiucleco.gov. All inspections requested prior to 9:00 PM will be scheduled for the next business day. Inspection requests between 9:00 PMFriday and 9:00 PM Monday will be scheduled for the following Tuesday. if you require any assistance please contact the Building Department at (772) 462-2172. Inspection Notes: Permit # Code Description PrIorijZ Schad, Date Res Description 1409-0009 380 MECHANICAL FINAL 1 1409-0009 999 FINAL INSPECTION 1 Total Inspections: 2 Inspector Inso. Date Report prepared on 9/3/2014 8:03:55 AM Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Receipt Online address: http://www.stlucieco.org/planning/permitfing.htm Quick Links: Permit Status Lookup Online Building Inspection System Daily Inspector Schedule Date: September 02, 2014 Receipt #: 0000101457 Permit Number: 1409-0009 Job Address: 8633 FLORENCE DR Amount: $84.00 Paid With: CHECK Check # 3869 Paid By: CUSTOM AIR SYSTEM Received By: ingraml Fee Description NBPSur934 N-BP Surcharge - Permi708/709 - HVAC (new sys)(1 &2 Fam Resid) NBPTru993 N-BP Trust Surcharge - Permi708/709 - HVAC (new Sys)(1 &2 Fam Res) NPermi709 N-Permit Fee - HVAC - (replacement sys)(1&2 fam resid) NBIMS651 N-BP BIMS Total: Fee Amount $2.00 $2.00 $75.00 $5.00 $84.00 9/3/2014 8:03:50 AM Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 i BUILDING PERMIT Online address: http://www.stlucieco.org/planning/permitting.htm Quick Links: Permit Status Lookup Online Building Inspection System Permit #: SLC 1409-0009 Confirmation #: 936 Issued: 9/3/2014 Job Location: 8633 FLORENCE DR City: PORT ST LUCIE Permit Type: MECHANICAL/HVAC RESIDENTIAL- Status: ISS Date Expired: 03/03/2015 REPLACEMENT SYSTEM Job Description: CHANGEOUT LIKE FOR LIKE 3TON, 13SEER,10KW SYSTEM Subdiv: LA BUONA VITA MHP Lot: 94 Block: Parcel: 3426-664-0093-000/5 Setbacks Left: Right: Front: Rear: Zoning: RMH-5 Number of Units: 1 Floors: 1 Buildings: 1 Square Footage: Flood Map: Flood Zone: AE Elev: 9 Contractor CURTIS A SAMMONS CUSTOM AIR SYSTEMS INC (772) 335-3232 1615 SE VILLAGE GREEN DR PORT ST LUCIE, FL 34952 ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Property Owner CYNTHINA R KOWALCZYK (772) 878-8418 50 ROCKLAND ROAD WEST BROOKFIELD, MA 01585 ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Property Owner GERALD K KOWALCZYK 1 (772) 878-8418 50 ROCKLAND ROAD WEST BROOKFIELD, MA 01585 Permit holder acknowledges through acceptance of this permit that separate permits must be obtained as required by the Florida Building Code including those for all electric, plumbing, mechanical, roofing and structural work. Further he/she acknowledges responsibility to comply with all requirements of the 2007 Florida Bulding Code and the St Lucie County Land Devlelopment Code. Issuance of this permit may be appealed to the St. Lucie county Board of Adjustment by an aggrieved party by filing a notice of appeal with St. Lucie County Growth Management Director within thirty (30) days of the, issuance of this permit in accordance with St. Lucie County Land Cevelopment Code, Section 11.11.00., Appeals. Building Permits shall expire and become null and void if work authorized by such Building Permit is not commenced, having called for and received a satisfactory Inspection within six (6) months from the date of issuance of the permit or if the work is not completed within 18 months (permit by contractor) or 24 months (permit by owner) from the date of issuance of the Building Permit in accordance with St Lucie County Land Development Code Section 11.05.01 (A)(2). NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this property that maybe found: in the records of this county, and there may be additional permits required from other governmental entities such as water management disitricts, state agencies, or federal agencies. s:553.79(10), F.S. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. a NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORIDNG YOU NOTICE OF COMMENCEMENT. s:713.135 (10(a), F.S. Carl Peterson Date Building Official