HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/06/2017
.COUNTY �"`
A -
Permit Number:
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
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:�
Address: 1624 SE TIFFANY AVE
Legal Description:
Property Tax 1D#: 3414-501-3503-000-5
Site Plan Name:
Project Name: RESERVE AT PORT ST LUICE
Setbacks Front Bark:
DETAILED DESCRIPTION OF WORK:
Commercial _ _ Residential x
Right Side: Left Side:
LIKE FOR LIKE A/C CHANGE OUT 2 TON
A/H MODEL # 14ACXS024 14 SEER
CONDENSER MODEL # LSM24223ES0002 5 KW
Lot No._
Block No.
CONSTRUCTION INFORMATION:
rtiona worT<to�Ee�� erforTne un�t�iis �;err7it-ciiec-k GfI app --Tye
I MVAC Gas Tank 17Gas Piping Shutters Windows/Doors
11Electric Plumbing Ln kl
Spriners Generator
�--..J � f—J Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2,200.00
OWNER; LESSEE:
Name TIFFANY PARK PARTNERS LTD
Address: 3475 PIEDMONT RD NE STE 1640
Sq. Ft. of FirstFloor:Floor:
Utilities: L , Sewer L _J Septic
City: ATLANTA _--V State: GA
Zip Code: 30305
Phone No. 772-245-4530
E -Mail: pm.apl@carrollmg.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: OSCAR A CALZADILLA
Company: UNICO AIR CONDITIONING COMPANY
Address: 25 .`SW CABANA POINT CIRCLE
City: STUART State: FL
Zip Code: 34997 Fax: 772-647-7544
Phone No. 305-528-1392 A
E -Mail: marty@unicohvac.com
State or County License: CAC1814920 A
If value of construction is $2540 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN
INFORMATION:
DESIGNER/ENGINEER: x— Not ApplicabieMORTC;AGE
COMPANY:
Name: TIFFANY PARK PARTNERS LTD
—_ Not Applicable
Name: OSCAR ACALZAOILLA
Address: 1624 SE TIFFANY AVE—
_
Address: 3475 PIEDMONT RD NE STE 1640
City; ArLANTA State:
Cit STUART
Y�
Zip: Phone
_State:
Zip: Phone:
--�_
FEE SIMPLE TITLE HOLDER: _ _Not Applicable
Name.:
BONDING COMPANY: Not Applicable
SW
Name:
Add ress:25CABANA POINT CIRCLE —�
Address:
Zip: - — _—_ Phone:- - -
—. I
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 concurrenry review: room additions,
accessory structures, swimming pools, fences, walls, Signe, 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 i11specti . you intend to obtain financing, consult with lender or an attorney before
commencingwork e ur Notice of Commencement.
i
Signature of Owner/ L Con oto as Agent for Owner i Signature or itrartor ettpider �—
STATE OF FLORIDA
COUNTY OF MAR TIN CUU NTY
The forgoing instrument was acknowledged before me
this ''- _day of JAN 20_ by
OSCAR A CALZADILLA
STATE OF FLORID
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this 17v day of •!Ah J 20_— by
OSCAR A CAL.?ADILIA
Name of person making statement T l Name of person making statement
Personally Known x OR Produced IdentificationI Personally Known X OR Produced Identification
Type of Identification �~I Type of Identification
Produced------------- I Produced
{Signature of Notar . PU ;Tic Sta�of F_WA U!RRc It`; (Signature of Notary Pini State of Florida )
MY COr�AM4SSlOtd � Fr 09121 j MARTA AG�J '
j Commission No. FF tet EXP±Rc��j� F 09512 i 11
yy�, �dzrHraers Commission No. N496121
o? Bandea'IhruN�'ntaryF(ihlwt' -_lpi• I - OMMISS10
--
s;,_ ;, ;;_:• : EXPIRES: March 9 2018
Bonded Thru No,ary Pubfc Unde v rilars
REVIEWS FRONT ZONING SUPERVISOR I PLANS I VEGETATION I SEA TURTLE MANGROVE
F7 COUNTER REVIEW REVIEW REVIEW I REVIEW I REVIEW I REVIEW
IDATE -------.-_`I —t --
RECEIVED
DATE --�. -- ---�-- - ----- — - ---------�
COMPLETED
Rev. $/2/17
—J