HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/2012018 Permit Number:
J --
M810
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
Address: 6100 BUCHANAN DR, FT PIERCE, FL 34982
Legal Description:
Property Tax ID #: 340260301410004
Site Plan Name:
Project Name:
Setbacks Front Back:
I DETAILED DESCRIPTION OF WORK:
Replace existing 4 ton unit with new,
Goodman 4 ton 15.0 seer system w110 kw heat
Models GSX16048 & ASPT49D
Right Side:
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit —check a
n�
t`� JHVAC Gas Tank E]Gas Piping
11 Electric Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4500.00
Residential X
Left Side:
apply:
Shutters
Generator
S. of First Floor:
Utilities: Sewer []Septic
Lot No.—
Block No.
Windows/Doors
Roof Root pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ELIZABETH BROWN
Name:
Address:6100 BUCHANAN DR
Company: TRACY ❑ STEELE AIR GOND. INC.
City. FT PIERCE State:FL
Zip Code: 34982 Fax:
Phone No. 772-971-0943
Address: 2750 SW EDGARCE ST
City: PORT ST LUCIE State: FL
Zip Code: 34953 Fax:
Phone No. 772-215-1974
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: tdsac@aol.com
State or County License: CAC035553
If value of construction is $2504 or more, a RECORDED Notice OT Commencement is requireu.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
N a me: ELIZABETH BROWN
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 6100 BUCHANAN DR, FT PIERCE, FL 34982
Address: 6100 BUCHANAN DR
City: FT PIERCE State:
Zip: Phone
City: PORT ST LUCIE State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 installatLon 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 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, consult with lender or an attorney before
commencinp, work or recording your Notice of Commencement.
Signature of Owne / Le /Contractor as Agent for Owner
Signature of Contra 4or/LCc�fise Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LUCIE
COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 20 day of SEPTEMBER 20M by
this 20 day of SEPTEMBER , 2Qtk by
TRACY D STEELE
TRACY D STEELE
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identifikation
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida
Si )
Commission
Notary Public SUM of Florida
Comm sI o. Ij
+� fltary ublic State OT Fiorlde
Daniel F Stacey
Daniel F Stacey
M Commission GG 251663
My Commission 40 251663
Expires 1
an
REVIEWS ERVISOR
PLAN MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPi -TED
Rev. $/2/17