HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 Permit Number:
' RECEIVED
Building Permit Application AUG 3 ?.018
Planning and Development Services o
Building and Code Regulation Division ST. Lucie County, 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: 2601 Lazy Hammock Lane, Ft. Pierce, FL 34981
Legal Description: Lazy Hammock Lot 4
Property Tax ID#: 2419-501-0004-000-8 Lot No.4
Site Plan Name: Block No.
Project Name: HVAC Change out
Setbacks Front 'Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change out AC unit like for like, replacing with 5 ton Carrier Performance, condenser 24APB660A003,
Air Handler F134CNP0601_00, 8 KW heat, 15 SEER
CONSTRUCTION INFORMATION:
Additional work to e e orme under tispermit—c—check a appy:
HVAC rI Gas Tank Gas Piping OGenerator
Shutters Windows/Doors
❑ aElectric Plumbing Sprinklers F] Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ $5500.00 Utilities: Sewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jerry&Melinda Hoeffner Name: Keith C.Thompson
Address:2601 Lazy Hammock Lane Company: AC Keith Inc.
City: Ft. Pierce State:FL Address: 690 SW Pueblo Terrace
Zip Code: 34981 Fax: City: Port St. Lucie State:FL
Phone No.772-332-9443 Zip Code: 34953 Fax:
E-Mail: Phone No. 772-519-1351
Fill in fee simple Title Holder on next page(if different E-Mail: ackeithl@aft.net
from the Owner listed above) State or County License: CAC1813976
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:
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
commencin ork or recp;ding Vour Notice of Commencement.
Signature of Owner/Les se ontractor as Agent for Owner Signa ure of Contractor/License Hol
STATE OF FLO IDA STATE OF FLORIDA
COUNTY OF ( LV U rF COUNTY OF S7
The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me
this__�_-.day of Lac,u>4 ,20_ by this I S� day of AV RV�A 20±C by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification c Personally Known OR Produced Identification,
Type of Id ratification Type of Idratification
Produced -L—D L Produced_ 1- L 7 Y'1 Z^'S a 3- 6"1-257
(Signature of Notary P - (Signature of Notary Publi S _ -
o`iPaY THEODORE SARANTOS o,,,,,,,,,�
Commission No� :` Notart(s�l� -State of Florida Commission No.GGD 83'�P� pUA11,1- RE SARANTOS
-- - Commission # GG 044773 f + __ Nota Public-State of Florida
♦ P: 3
N1y Comm.Expires Nov 3.2020 °y 1- tea,; Commission# GG 044773
My Comm. E
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DATE
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DATE
COMPLETED
Rev.8/2/17