HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06128/2018 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
Address: 10106 US Highway 1, Port St Lucie
Legal Description:
Property Tax ID #: 3414 501 3715 200 6
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING 3 TON SYSTEM WITH;
RUUD 3 TON 16.0 SEER Wi10KW HEAT
LIKE FOR LIKE
MODELS RA1636 & RH1T3617
[2 of 2] systems
CONSTRUCTION INFORMATION:
A1 13 nal worK to e e Orme un er t is permit— c ec
[]Gas
a appy:
[]Windows/Doors
ZHVAC Gas Tank Piping
_ Shutters
FI Electric Plumbing Sprinklers
LJ Generator Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
O Building Height:
Cost of Construction: $ 4500.00 Utilities:,n
Sewer Septic
OWNERAESSEE:
CONTRACTOR:
Name10-100 HOLDINGS LLC
Name: TRACY D STEELE
Address: 10100 US HIGHWAY 1
Company: TRACY D STEELE A1C INC
City: PORT ST LUCIE State: FL
Address: 2750 SW EDGARCE ST
zip Code: 34952 Fax:
City: PORT ST LUCIE State: FL
Phone No. 772-323-1610
Zip Code: 34953 Fax: 772-3364171
E -Mail:
Phone No. 772-336-2448
Fill in fee simple Title Holder on next page ( if different
E -Mail: tdsac@aol.com
from the Owner listed above)
State or County License: CAC035553
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; 10-100 HOLDINGS LLC Name: TRACY D STEELF
Address: 10105 US Highway 1, Port St Lucie Address: 10100 US HIGHWAY 1
City: PORT ST LUCIE State; City; PORT ST LUCIE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 2750 SW EDGARCE ST 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 or recording our Notice of Commencement.
a
Signature of Owner/ Le ee/ on actor as Agent for Owner Signature o Cctorontr nse Holder
STATE OF FLORIDA STATE OF FLORIDA7
COUNTY OF r tit COUNTY OF � (—)�_—'
The forgoing instrument was acknowledged before me The forgoing instrujMgmt was acknowledged before me
thisa dayaf �u+.1L 20) by thiskdayof --.11 Kms/ 20�by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
r
(Signature of Notary Public- State of Florida }
Name of person making statement
Personally Known * OR Produced identification
Type of identification
Produced
11�
(Signature of Notary Public- State of Florida )
Commissia No"'".' •.... Commis°
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396_Qi r�c•� _c A- W P 4Ce.t* RVISOR PLANS
COUNTER REVIEW REVIEW REVIEW
Rev. 8/2/17
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