HomeMy WebLinkAboutBuilding Permit Application Jun 181511:58a Jack Frost A/C of So Fla 772-336-9032 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G d
Date:
06/18/15 Permit Number:
S ,.
RECEIVED JUN 18 N
Building Permit Application
Pianning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 10725 S.Ocean Drive., Lot#477, Jensen Beach,34957
Legal Description: HOLIDAY OUT AT ST LUCIE-SEC B BLK M LOT 33 AND EQUAL PRO-RATA INTEREST IN COMMON ELEMENTS(OR 1941-2736)
Property Tax ID#. 4511-502-0033-000-2 'Lot No.477
Site Plan Name: Block No.
Project Name: Holiday Out
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace a/c equipment, like for like
Trane 3.0 ton 14.2 SEER Package Unit,with 8kw heater
Model 94TCY4036
CONSTRUCTION INFORMATION:
Acid Itiona I work to be nertorme under this permit—check all appy:
aHVAC Gas Tank DGas Piping _Shutters a Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 5100.00 Utilities:cnSewer 1:Septic Building Height:
OWNERf LESSEE: CONTRACTOR:
NameJohn Nolte Name: Jacques C.S6egelman
Address:10725 S. Ocean Dr.,Lot#477 Company: Jack Frost AC of South Florida,Inc.
City: Jensen Beach State:F L Address: 1716 SW Biltmore Street
Zip Code: 34957 Fax: City: Port St.Lucie State:FL
Phone No.732-682-4190 Zip Code: 34984 Fax: (772)336-9032
E-Mail: Phone No. (772)336-9030
Fill in fee simple Title Holder on next page(if different E-Mail: jackfrostnodda@aol.com
from the Owner listed above) State or County License: State CAC1815725/Co. 25113
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Jun 1D1G11:58a Jack Frost 772�88��2 p
A/C /.3
SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMATION:
Name: Name:
Address: Address:
city: State: City_ —State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: NotApplicable BONDING COMPANY. x NotApplicable
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 in"dIcated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Luciecounty makes no representation that is granting a permit will authorize the permit holderto 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 consultwith 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 roorns 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 jobs(te
before the first inspection. If you intend to obtain financin&consult with lender or an attorney beford
commen)mng work orrecarding your Notice of Commencement.
Signatur OEOwnerlrsent/Lessee Signature of tV'Nntractor/Ucens-e-IFol—der
STATE OF FLORIDA STATE OF LORIDA
COUNTYOF St. Lucie COUNTYOF St.Lucie
The f r instrument was acknowledged before me Thefor Ing instrumlbt was acknowledged before me
this ay of 20[E by this imay of JtA_ 20ZL�DbV
Jacques C. Stlegelmart Jacques C.Stiegelman
(Siddature of Notary Public-State of Florida) ature of Notary Public-State of Florida
Personally Known XX OR Produced Identification N/A Personally Known XX OR Produced Identification NIA
Type of Identification Produced Type of Identification Produced
Commission No._ FF007935 R.PARSONS Commission No. FF007935 &a
Kio-rARY PUBLIC 'kMSTINA R. IS
IDA NOTARY PUBLIC
OF FLOR Aft
M#IFF00-935-- OF FLUK10A
-We ' Com IT COMIrNIFF007935
Revised 07/15/2014 Expires 4123120 Expires 4/2312017
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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