Loading...
HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 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 Residential x PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 6203 Arlington Way, Ft. Pierce, FL 34951 Legal Description: Portofino Shores (PB 43-6) LOT 172 (or 4124-524) Property Tax ID #: 1312-501-0107-000-9 Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: AC Change Out 5 Ton 14.25 Seer 10 KW Heat. No Ductwork Lot No. 172 Block No. Haamonal worK to 0e rTormea unser tnis permit- cnecK all apply: HVAC f] Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors ❑ Electric ❑ Plumbing Sprinklers ❑ Generator ❑ Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 5394. Utilities:Sewer F]Septic Building Height: OWNER/LESSEE. CONTRACTOR: Name William & Katherine Kelly Name: Dean Staley Address: 6203 Arlington Way Company: Breathe Kleen Air City: Ft. Pierce State: FL Zip Code: 34951 Fax: Phone No.607-221-1131 E -Mail: Address: 735 D Commerce Center Dr. City: Sebastian State: FL Zip Code: 32958 Fax: 772-918-4963 Phone No. 772-918-4708 Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: breathekleenair@yahoo.com State or County License: CAC1814227 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION; DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable 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. 1 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 d'n o w rk or recordin our Notice of Commencement commen2 F2 y gg Signature of Owner/ssee/Contractor as Agent for Owner Signature of Contractor/License Ho r STATE OF FLO n STATE OF FLOjtlD n JIDA COUNTY OF h d "a t iL.� t.- COUNTY OF t Y� t G.� K c �C✓ The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me � day T1. 2Q�L by this 5 day of 2019 by this of rv2 Name of person making statement Name of person)making statement ✓ Personally Known / OR Produced Identification Personally Known OR Produced Identification _ Type of Identification Type of Identification Pr duced Produced KELLY M BECKERT L_, PU trpY P„ =°' �n KELLY M BECK MY COMMISSION #G _ r°` a MY COMMISSION #GG159 75 nature of No ar u lic- State of FI ( g Y IXPIRES: NOV i4, Bonded through 1St Stat (Si nature of otary P ic- State EXPIRES: NOV 14, 2021 � �nded 1st State Insurance �„ through ) ��, � G � �� Q „d No. I ea Commission No. ea ommission REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 SERVICE REPORT Liquid psig Suction psig Fan Amps Compressor Amps Heart Recovery Contactor Capacitors Surge Protector Line Dryer R-41 Oa/R-22 Cond. Breaker * Cond. Coil Accumulator Fan Amps Drain Tabs K.W. Size Relays Duct System Tighten Electrical Unit Rusting *Evaporator Coil Temp. Drop. / Breaker T-Stat Primary Secondary NO WARRANTY ON DRAIN LINES S-139' Xi 59 158 mom Breathe Kleen Air JAM DSL ENTERPRISES f.Af.1914777 Qualitg Service Everg Tune 0 BreatheKleenAir@yahoo.com 0 (772)918-4708 BREATH EKLEENAIR.COM © 735 D Commerce Center Dr Sebastian, FL 32958 AIR CONDITIONING & HEATING DUCT CLEANING Brevard County St. Lucie County Indian River County Martin County NAME a DATE /y INVOICE# 1977 DO SO ORDER AS OUTLINED ABOVE. IT IS AGREED THAT THE SELLER WILL RETAIN TITLE TO ANY EQUIPMENT OR ADDRESS ,/ MAKE MODEL YEAR CITY if C STATE / ZIP A/H CHARGE PHONE / G EMAIL COND. ANY DAMAGES RESULTING FROM THE REMOVAL THEREOF. I AGREE TO PAY ALL COSTS OF COLLECTION, INCLUDING ATTORNEY FEES, STATURTORY RETURN CHECK CHARGES RECOMMENDATIONS DESCRIPTION OF WORK APPLY. 20% RESTOCK FEE ON ALL CANCELLATIONS. I AM • R I am satisfied with the service I received Today: = Y = N Overall, how would you rate the value you received from Breathe Kleen Air? Excellent Good Fair Poor PARTS WARRANTY, All parts as recorded are warranted as per manufacturer specifications. We do not guarantee others parts than those we install. If repairs later become necessary due to other defective parts, they will be charged separately. * PLEASE NOTE: There will be an additional charge for chemically treated cleaning. EMERGENCY SERVICE: All PMA and warranty service between 8:00 am - 5:00 pm, Monday - Friday excluding legal holidays. All other work subject to additional char NOT RESPONSIBLE FOR ANY WATER DAMAGE is im I HAVE THE AUTHORITY TO ORDER THE ABOVE WORK AND SUB - DO SO ORDER AS OUTLINED ABOVE. IT IS AGREED THAT THE SELLER WILL RETAIN TITLE TO ANY EQUIPMENT OR TOTAL TRIP MATERIAL FURNISHED UNTIL FINAL & COMPLETED PAYMENT IS MADE, AND IFTHE BALANCE IS NOT MADE AS AGREED, THE SELLER SHALL HAVE THE RIGHTTO REMOVE THE SAME AND THE SELLER WILL BE HELD HARMLESS FOR CHARGE TOTAL ANY DAMAGES RESULTING FROM THE REMOVAL THEREOF. I AGREE TO PAY ALL COSTS OF COLLECTION, INCLUDING ATTORNEY FEES, STATURTORY RETURN CHECK CHARGES APPLY. 20% RESTOCK FEE ON ALL CANCELLATIONS. I AM AWARETHAT I HAVE A 3 -DAY RIGHT OF RESCISSION. DOWN PAYMENT _ ATE DATE:-- CASH C.C. CASH CK.# FINANCING Ilt 'IE- BALANCE DUE _ Upon Completion