HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10-18-18 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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 1803 HAZELWOOD DR
Legal Description:
Property Tax lD #: 2433-502-0025-000-8
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Replace existing 4 ton system with new;
Goodman 4 ton 16.0 seer w110kw eat
Models GSX16048 & ASPT49D
CONSTRUCTION INFORMATION:
itinna I wn rk to he ner orme un er
L_JHVAC u Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4000.00
Right Side
this permit—ci
❑Gas Piping
0 Sprinklers
Left Side:
all apply:
_ Shutters
Generator
Sq
. of First Floor:
Utilities: 0 Septic
OWNER/LESSEE:
NameMichael Oostdk
Address: 1803 Hazelwood Dr
City: Ft Pierce State:Fl
Zip Code: 34982 Fax:
Phone No. 772-528-2806
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:
Lot No.
Block No.
aWindows/Doors
DRoof Roof pitch
Building Height:
Company: Tracy D Steele Air Cond. Inc
nrldracc- 2750 SW Edgarce St
City: Port St Lucie
Zip Code: 34953 Fax:
Phone No. 772-336-2448
E -Mail: tdsac@aol.com
State or County License: CAC035553
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: FI
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: MICHAEL OOSTYDK Name:
Address: 1803 HAZELWOOD DR Address'. 1503 HAZELWOOD DR
City: FT PIERCE State: City: PORT ST LUCIE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: JNot Applicable
Name: Name:
Address:2750 SWEDGARCE 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
swhich tructure. Pleasecconwith
sult w the our Hlome Owers Assors ciation ndiation rev rules,
bylaws
ur deeor d for any covenants tr restrictions which maor
apply. such
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.
4
Signature of Owner/ Les ee/C t ctor �asAgent for Owner Signature of Contra for ' ense 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 l day of a. 20)R by this __a day of CU 20($ by
TRACY D STEELE TRACY D STEELE
Name of person making statement Name of person making statement
Personally Known X OR Produced Identification 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 }
Commissi Commissi al)
-pc�Nc Stere of F
Notary Public Stag+ of Florida Daniel F SlaceY
Daniei F Stacey My Commission GG 251953
s M commission GG 251853 0/
Expires 0
REVIEW PERVISOR PLANS I EA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17