HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 4a s,<w SS3
Date � ,S1 4 Permit Number: SI
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Building Permit Applicati n2919Planning and Development Services
Building and Code Regulation Division ST , Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 22 Lake Vista TRL Apt 103
Legal Description: VISTA ST LUCIE BLDG 22 UNIT 103 (OR 580-1670)
Property Tax ID#: 3422-500-0297-000-8 Lot No. UNIT 103
Site Plan Name: Block No. BLDG 22
Project Name: EVELYN THOMPSON
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC CHANGE OUT OF A 2 TON 5KW YORK UNIT
CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit–check all app y:
—HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑✓
11 Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 3100 Utilities:❑Sewer❑Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name EVELYN THOMPSON Name: GRETA B SMITH
Address:22 LAKE VISTA TRL# 103 Company: ALL YEAR COOLING AND HEATING
City: PORT ST LUCIE State:FL Address: 1345 NE 4TH AVE
Zip Code: 34952 Fax: City: FORT.LAUDERDALE State: FL
Phone No.561-727-5660 Zip Code: 33304 Fax:
E-Mail: Phone No. 954-566-4644
Fill in fee simple Title Holder on next page ( if different E-Mail: DDANIELS@AYCAIR.COM
from the Owner listed above) State or County License: CAC058160
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW 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 thepermit 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, consul with lender or torney before
commencin o r recording our Notice of Commencement.
s
Sig a of ner/Lessee/Contractor as Agent for Owner re o Contract r/License H r
STATE O FLORIDA STAT F FLORIDA
COUNT OF SAINT LUCIE COLIN Y OF BROWARD
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1—day of MAY 20 18 by this ' day of MAY 20 18 by
DIMITRIUS DANItLS DIMITRIUS DANIELS
(Name of person acknowled (Name of person acknowledging)
(Signature of N ary Public-St f Florida ) igna of Notary P lic-State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identif�aSType of Identification Produced V Typeof Identification Produced
p' �1`s1F��5.cTr1 0 F�
Commission No. ( PU FF 20`� Commission No. \M�oM (€s�7c`o�eifp
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Revised 07/15/2014
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