HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:a -'?- h2 Permit Number: /(C C)0
CEO
Building Permit Application FEB 416
Planning 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 XXXXXX
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED"IMPROVEMENT LOCATION.
Address: 8105 Kiawah Trace, pORT sT. IUCIE,fl. 34952
Legal Description. POD 25 AT THE RESERVE LOT 9 (OR 2014-2675)
Property Tax ID#: 3327-705-0010-000-0 Lot No.
Site Plan Name: Block No.
Project Name: AC Changeout
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:',;" "
R&R air handler and outside unit. rlfla,
CONSTRUCTION.INFORMATION."
Additional workto e" er orme under this permit—check a appy:
❑✓_HVAC Gas Tank F]Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
�1 dd
Cost of Construction: $ /c)��y�/ Utilities: _Sewer[]Septic Building Height:
OWNER/LESSEE: _ CONTRACTOR:
Name Linda Collins Name: Dennis Dean
Address:8105 Kiawah Trace Company: LSCI, Inc.
City: Port St, Lucie State:FL Address: 19321-C US Hwy 19 N STE 500
Zip Code: 34952 Fax: City: Clearwater State:FL
Phone No.772-595-0223 Zip Code: 33764 Fax: 727-683-9958
E-Mail: Phone No. 727-571-4141
Fill in fee simple Title Holder on next page ( if different E-Mail: Permits@suntecsolarenergy.com
from the Owner listed above) State or County License: CAC009274
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Q,'1:\q;—_s
SUPPLEMENTAL CONSTRUCTION LIEN LAIN 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:
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
cooi.mencingwork or recording our Notice of Commence nt.n
� I
of Owner/Agent/Lessee at of Contractor/License Holder
STATE OF FL LDA STATE OF FLJFRID
COUNTY OF ;jr,� COUNTY OFfs%'S
The for oin instr�l t was acknowledged before me The f oing instr�tm nt was acknowledg before me
this day of \ 20 ft by this day of 20JU by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida ) Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification X_' Personally Known OR Produced Identification 'V
Type of Identification PrT __L L— Type of Identification Produced
Commission No. e
J?I6a'l)CARLO MATO Commission No.
J
"app ^•. 1-
9ffl' ARLO MATO
MY OMMISSION#FF039278 `_
`'•:F OF rt�F:` EXPIRES Jul MY COMMISSION--FF039278
-u;1 398-0153 ry "•?saF�o?: EXPIRES July 24.2017
Floridallota Service.com ,'•
Revised 07/15/2014 (407)398-0153 FloridallotaryService.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
JOSEPH E, SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 41.66866 OR BOOK 3843 PAGE 2787, Recorded 03/08/2016 at 11:1.9 AM
! Permit Num er 1 A r '� . 146 5
Parcel 10 Number 33al`- orwt p44.0-- b
NOTICE OF COMMENCEMENT
State of Florida
County of Pinellas
THE UNDERSIGNED hereby gives notice that improvements Will be made to certain real property,and in accordance with Section 713,13 of the
Florida Statutes,the following Information is provided in this NOTICE OF COMMENCEMENT, w i
1.0escriptionofproperty(legal desorlpflon): Ria• •�� �,� tea.,. � t l..r,►••• •�,Q,r• I.! . ,,..." �
a)Street(job)Addross: 15 or It I Aj4 Q*n �--
Z,General description of Improvements: :r"n6'hol of ow woo• l•�ea.�-�!�.! .:..... , � "�.� ......-...,...
1;.f •' ..
3,0wner Information or Lessee Information if the Leasee contracted for the improvement; .. >a�'a,:�,,•..
a)Nameandaddress: (.^ C.,t+1k.+r,y,. . g�0 al,,art.�► 1 rc►t ..... ar�.. .'4�"C to .l.@.�...,�r4. .:, .i2;;. �;;., (
b)Name and address of roe simple tiVeholder(if different than Owner listed above)
'.l 'i .Y ik.r•.:� I
C)interest in property:
44ontractor Information
a)Name and address: LSCI,Inc 19329-G US Hwy 19N,Suil0 600,Clearwater,FL 33764 u;
b)Telephone No.: 727.571.4141 �� Y
Fax f`f0,;(optional) 727-540.4844 "z`
,
$,Surety(it applicable,a copy of the payment-bond is attached) + -
a)Name and address: f i ?�'. °¢¢'
b)Telephone No.: ) ,
o)Amount of Bond:
A•
CLender
a)Name and address:
,:....I:._.(z Cr
b)Telephone No,: ;;;�,• +
7,Persons within the State of Florida dealgnafed by Owner upon whom notices or other documents may be served as provided by Section
r
713.13(1)(a)7,,Florida Statutes:
a)Name end address:
b)Telephone No,: Fax No,:(optional)
8,e,ln addition to himself or herself,Owner designates of
to receive a copy of the Llenor's Notice as provided in Section 713.13(1)(b),Florida Statutes,
b)Phone Number of Person or entity designated by Owner: i
9.Expiration date of notice of commencement(the expiration date may not be before the completion of construction and final payment to the
contractor,but will be 1 year from the date of recording unless a different date is specified); _ :20
WARNINTO G OWNER:ANY PAYMENTS MADE'SY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 113.13,FLORIDA STATUTES,AND CAN RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON ;
THE JOB SITE BEFORE THE FIRST INSPECTION, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ,
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
.... . , . .....................................
Uncle►penally of perjury,I declare that I have read the foregoing notice of ornmencement and that the facia stated therein are true to the best of my
knowledge d
gnaiownor or Le a,or tete rDeas e'a iAulhnrl�ea Ufhcer or�'!1<tfo)1Menagar) err( d Ronda& Oram)
The Tore o�ng instrpment wa ck pledged haters me 011�r dray of e rl,V�✓'}� 20
by j/) ,�, (/ f1$ es (typo or authority.o.g omcer,uustaa,aeatnay in fao)
for —•--�- as
IName or Po nan) (typo cr ault+anty., a.p.091cat,trustee,attotney In rant)
for """"-�-� (name p yo of whom Instrument was executed).
Personally Known Produced IDType of ID � Notary inae l /7
Print namme
h' .JUAN CAI'iLC) MATO
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