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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 12-2-18 Permit Number: ...... .. ..._............ . I J' s 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 PERMIT APPLICATION FOR: Mechanical PROPOSED IMPROVEMENT LOCATION: Address: 4160 N Hwy AIA, Unit 1103A Legal Description: Property Tax ID #: 1423-506-0066-000-5 Site Plan Name: Project Name: Setbacks Front Back:_ Right Side: Left Side: Lot No. Block No. I DETAILED DESCRIPTION OF WORK: I I Like for like AC changeout. 3.5 ton 14 seer with I Okw heat CONSTRUCTION INFORMATION: CONTRACTOR: Name Linda Merrick Name: Shyan Wojtczak ��itiona workto a er orme under RIHVAC 13 this permit —check ©Gas Piping a Address: 6903 Cabana Lane appy: Shutters Q Windows/Doors Fill in fee simple Title Bolder on next page ( if different from the owner listed above) E -Mail: coolairsol@gmail.com Gas Tank _ Electric 0 Plumbing 05prinklers Generator LJ Roof Roof pitch Total Seq. Ft of Construction: 4,600 S Ft. of First Floor: 0 Cost of Construction: $ Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Linda Merrick Name: Shyan Wojtczak Address: 451 Chukker Valley Company: Cool Air Solutions of Florida, Inc. City: Ellisville State: MO Zip Code: 63021 Fax: Phone No. 314-374-3859 Address: 6903 Cabana Lane City: Fort Pierce State: FL Zip Code: 34951 Fax: 772-801-5398 phone No 772-634-0491 E -Mail: Imerrick@charter.net Fill in fee simple Title Bolder on next page ( if different from the owner listed above) E -Mail: coolairsol@gmail.com State or County License: CAC# 1819009 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: 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 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 commencing work or recording your Notice of Commencement. Rev. 8/2/17 d�r - C Signature okontractor/L(6ris6 Holder Signature of -Owner/ Lessee/ o t for as Agent for Owner STATE OF FLORID STATE OF FLORIDA �- COUNTY OF d1IQn t? CJ— _ COUNTY OF -k nab Q, � 1 Theorgqing instrument was acknowledged before me Iri-day The forgoing instrument wa acknowledged before me '`day �Jb,,J2.rn this of 1t fYL�aq 24�Zby this of 20 by a~�.-Ion cuc_)&L-c" 1L nLuuDLu4J22_ . -"Name of p sre on making statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced e_r;&Q -'r, nfw'f­ � 4, J[ Type of Identification ProduceK:� D!'4 ok-F',— CCS r �5 DANIELLE L HARRIS - 5tate of Floridao:�y ,* P., DANIELLE L HARRIS N>7tary Public State of rltvaitfNotary Public (Signature of Not y"' . = Sl t� #nF id eU 10,C(Seal) MIS{�b f Ex� iscgt e 2 orida f ltn"-N Co�Lmrrr� Commission No.GC4 t S (Seal) (4�p D S G' 9 ,5 v s` -P SC(4" !0, Zo --z REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17