HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7126/18 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
Address: 4160 N Hwy Al Unit 503A
Legal Description:
Property Tax ID #: I LA �3 - p(P e oaDL� - doo - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:. Left Side:
DETAILED DESCRIPTION OF WORK:
Like for like 3.5 tan 14 seer with 14kw heat
CONSTRUCTION INFORMATION:
Additional work toe e Orme under t is permit —check a appy:
HVAC f] Gas Tank E]Gas Piping Shutters Windows/Doors
❑ Electric ElPlumbing Sprinklers ❑ Generator Roof O Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ $3450.00
S Ft. of First Floor: _
Utilities: Sewer ❑ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William & Kathleen Rapp
Name: Shyan Wojtczak
Address:4160 N Hwy A1A Unit 503A
Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce State:FL
Zip Code: 34949 Fax:
Phone No.
Address: 6903 Cabana Lane
City: For Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No. 772-634-0491
E -Mail:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
E -Mail: coolairsol@gmail
State or County License: CAC # 1819009
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name: T
Address:
Address:
City: State:
Zip: Phone
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.
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 your Notice of Commencement.
_ �i
int �Lv
Signature of wner/ Lessee/C &aJtor as Agent for Owner
Signature of ontractor/Lice s o der
STATE OF FLOR A
STATE OF FLORIDA
COUNTY OF �L3C i
COUNTY OF S� . L t._ -I P
Th�oing instrument was acknowledged before me
-clay
The forgoing instru nt was acknowledged before me
thifc day of ��?I 26__Q5 by
thi of 20i� by
.
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Jaamme of person making statement
14ame of personYnaking statement
Personally Known OR Produced Identification X
Personally Known OR Produced Identification
Type of Identification
Type of Iden ific�a-tion�
1�
Produced 11 L—
Produced J
(Signature o Nota Public- State of Florida
N
(5i nature f Notary Public- State of Florida )
Stephanie oure t y Stephanie
Commission No. �� NOTARYP W6mission No. FE 'fJ ZSYI ( NOTARY
pwo_i STATE OF LORIDA � ' STATE OI
Comm# FF9
�i
7381 Comm# FI
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17