HomeMy WebLinkAboutBuilding Permit Application JUN-15-2015 10:13 P.02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 tis Permit Number: �5OG ' da5$
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= , RECEIVED JUN 15 ?01
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce F4 34982
Phone:(772)462-1553 Fax:(772)462-1578 1Commercial Residential x
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMMOV „s.LLr r ,• '; �
Address: 8722 TOMPSON POINT RD
Legal Description: TOMPSON POINT PUT AT PGA VILLAGE LOT 6
Property Tax 1D#: 3327-704-0007-000-3 Lot No.6
Site Plan Name: Block No.
Project Name: CAMPAGNOLA RESIDENCE
Setbacks Front Back: Right Side: Left Side:
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REPLACE EXISTING SYSTEM WITH LENNOX EQUIPMENT
XC20-024 CBX32MV-024/030 2 TON 20 SEER 5KW
CONSTRIJcw ;! ;...qi":4;r:P`''• ;'' y' •:;1 r•1•tur+k'' 9T.:.�•wp,.c.";• f
I+�"�: �l,a. •f. . ..4 ,r •Vie.r•N�il• !iT'r
Acla.1tional work to 0 rformed uncler this perms -check all appy:
❑✓HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
CGenerator
11
Electric Plumbing Sprinklers Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 7335.00 Utilities:12 Sewer U Septic Building Height:OWN
..1' li .9. ..�.• :.h+1. �ryl•V• y, iii•I ,I•
Name LARRY CAMPAGNOLA Name: STEVE SANDERS
Address:8722 TOMPSON PT RD Company: STEPHEN K DENNY
City: PORT SAINT LUCIEState•FL Address: 408 COMMERCE WAY
Zip Code: 34986 Fax: City: JUPITER State:FL
Phone No.712-468-9598 _ Zip Code: 33458 Fax: 561-746-2581
E-Mail: Phone No. 569-743-9554
Fill in fee simple Title Holder on next page(if different E-Mail: RSANDERSOSTEPHENKDENNY.COM
from the Owner listed above) State or County License: CAC 1813800
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
JUN-15-2016 10:13 P.03
CERTIFICATION:
nisapplicarioti is hereby made to obtain a permit to do the work and installations as indicated,and to obtain a cert;flcatc of capacity,
if applicable,fbr the permitted work. I certify that no work,or installation has commenced prior to the issuance ofa permit and that all
work wil t Ere performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
may be reclu ired for ELECTRICAL, PLUMBING,SIGNS,WELLS,POOLS,FURNACE$, BOILERS,HEATERS,TANXS,
AND AIR CONDITIONER%FENCES,ETC.,not otherveisr,included with this building permit application.
St, Lucie County makes no reptesentation that its granting of a permit will authorize the permit holder to bad the subject structure
whioh is in contlict with any applicable Homeowner Association rules, bylaws or any covenants that may restrict or prohibit such
structure. mense consult with your Homeowner's Association and review your deed for any restrictions which may apply.
The following building permit applications are exempt from undergoing a full concurrency review. room additions. accessory
structures (ali types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non-
residential use.
NOTICE TO OWNER: YOUR rAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR.TNIPROVEMENTS TO YOUR PROPERTY, A NOTICE OF
COMMENCEMENT 1�47JST BE RECORDED AND POSTED ON THF.JOBSrM BEFOn THE
FIRST INSPECTION. IF YOU RqT]TiqD 7-0 OBTAIN FINANCING,CONSULT WI�M YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
NOTICE TO APPLICANT. IF IT IS NOT YOUR FlGfff,TITLE,AND INTEREST THAT IS SUBJECT TO
ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT,YOU PROMISE IN
GOOD FAITH TO DELIVER A COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO
THE PERSON wHosr,PROPERTY is suBjEcT To ATTACHMENT.
xTw-t 4 Fit F®R coNpucrop- NATURE C6 TRA R SI(
STATE Or, FLORIDA pin STATE OF FLORIDA
COUNTY 01:' COUNTY OF
The foregoing instrument was acknowledged before' The foregoing instrument was acknowledged before
me this_d.. slay of:j.� 20 l�L,
by
byLajCxL.1 OL M oaca�
who is personally known r has produced who Is personally known or
h
as identification, —ast tificati
Ig ure of. otary ------
oa OWNINQ
Commission LSI(XFQ�_A MI!;C1 y 00411M DN#FF036576IC inmission No.
EXPRE W 2 2017
8! my 21,207 EXP!
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NOTE: TWO (2)SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTAW'ZED. IF APPLYING FOR
THIS WILDING PERMIT AS AN OWNER)BUILDEP.,THE, OWNER.MUST PERSONALLY APPEAR To SIGN
THIS A(IPLICATION IN THE OFFICE LISTEI)ON THE)FRONT OF THIS AppLlpATION.
OWNER BUILDER AFFIDAVIT WILL BE=4 QUIRED FOR ALL OWNER/BUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.