HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/25/18 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 Commercial X Residential
PERMIT APPLICATION FOR: Mechanical
Address: 9545 RANGELINE ROAD
Legal Description:
Property Tax ID#: 4201-111-0001-010-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE HVAC CHANGEOUT;
4 TON 14.5 SEER 10 KW
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all h apply:
❑✓_HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator El Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 5997.00 Utilities:Sewer 11 Septic Building Height:
Name CHEM-TEX SUPPLY CORP Name: CHRIS LANGEL
Address:3901 NW 115 AVE Company: SEACOAST A/C
City: MIAMI State:FL Address: 3108 INDUSTRIAL 31st STREET
Zip Code: 33178 Fax: City: FT PIERCE State: FL
Phone No.ALLIED UNIVERSAL Zip Code: 34946 Fax: 772-466-3053
E-Mail: LINCOLN 305-888-2623 (EXT 0133) Phone No. 772-466-2400
Fill in fee simple Title Holder on next page ( if different E-Mail: DANISEACOASTAIR@AOL.COM
from the Owner listed above) State or County License: CMC035421
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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
commencing work or recording our Notice of Commencement.
V_�i ��w yu� s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCIE
The r ing in st ment was acknowled before me The f r oing instr ment was acknowledg before me
thi�day o 21tby this day of 20 �by
CNRIS LANGEL CHRIS LANGEL
(Name of person acknowledging) (Name of person acknowledging)
Signature of Notary Public-State of Florida ) ignature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
EgEMP' pp WFSE
Commission No. FFss aes (� 1.E W J4 ommission N . F e DANELLEy6�459
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MY EOM niary i6'20 XPIRES February
Revised 07/15/2014 ,53 E rwM+'ND' � ^U7eyU,s3 rNoa
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS