HomeMy WebLinkAboutPERMIT APPLICATION- ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12-1-17 Permit Number:
011m, W11 ."Mi
Building Permit Application
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 X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 131 CAMINO DEL RIO > �drf Sa,►n - Lycte_ ,�L 3-fq S2-
Legal Description:
Property Tax ID#: 00-56-56 Lot No.
Site Plan Name: Block No.
Project Name: AC CHANGE OUT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE OLD AIR CONDITIONING UNIT AND INSTALL NEW AC SYSTEM, 14 SEER WITH A 10 KW PACKAGE UNIT FOR
RESIDENTIAL PROPERTY. 4 -Lof is PAC Unl t
CONSTRUCTION INFORMATION:
Additional work to be performed un er t is—permit—ccheck all app y
ZHVAC Gas Tank Gas Piping Shutters F] Windows/Doors
11 Electric Plumbing F]Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3744 Utilities: F]Sewer D Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameANNA MAY MUELLER Name: FREDDY GUILLEMI
Address:131 CAMINO DEL RIO Company: INDOOR AIR CARE
City: ST LUCIE COUNTY State:FL Address: 1934 SW BILTMORE STREET
Zip Code: 34952 Fax: City: PORT SAINT LUCIE State:FL
Phone No.772-340-0839 Zip Code: 34984 Fax:
E-Mail: A t)M- MGls 1 hp tffi t.k) . C.Q►"►',7 Phone No. 772-985-3178
Fill in fee simple Title Holder on next page( if different E-Mail: INDOORAIRCARE@ATT.NET
from the Owner listed above) State or County License: CAC186063
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X 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:
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 cK recording our Notice of Commencement.
1"L
Signature of Owner/L see/Contra for as Agent for Owner Signature o ontractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1 day of DEC ,20t_'� by this 1 day of DEC 203 by
®111\f(A IKY-64 0-1 MCI AC%d' MONICA KRACH MELGAR
Name of person making statenent Name of person making statement
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
7
(Signature of Not Public-State of Florida (Signature of Notary blic-Stat ot Florida
OX—OFM
MONICA MELGAR KRACH
ON A MELGAR KRACH %&PMISSION#GG13128
Commission No. GG131286 0�!"•'9� Commission No. GG131286 Q�(��
n ISSION#GG131286 IRES:AUG 03,2021
EXPIRES:AUG 03,2021 Bonded through 1st State Insuran e
Bonded through 1st State Insurance
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17