HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12-4-18 Permit Number:
COUNTY
F L® R I 6 A
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
230D 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: 5207 Deer Run Dr.
Legal Description:
Property Tax ID #: 1313-502-0025-000-6
Site Plan Name:
Project Name.,
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AC Changeout like for like 4 ton 16 seer with 1 Okw heat
Lot No.
Block No.
CONSTRUCTION INFORMATION;
Additional work to be ertormed under this permit— check all appy:
HVAC Gas Tank E]Gas Piping _ Shutters E]Windows/Doors
11Electric❑ Plumbing Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ $3,700.00
S Ft. of First Floor: _
Utilities Sewel� Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Markes Ervin
Name: Shyan Wojtczak
Address: 5267 Deer Run Dr
Company: Cool Alr Solutions of Florida, Inc.
City: Fort Pierce State: Fs
Zip Code: 34951 Fax:
Phone No. 772-579-8961
Address: 6903 Cabana Lane
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No. 772-634-0491
E -Mail:
Fill in fee simple Title Holder 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 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.
Signature o Owner/ Lesse ontractor as Agent for Owner Signature of-tontractor/Li04olcler
STATE OF FLORI STATE OF FLORID
COUNTY OF COUNTY OFA
The for mg instr ent was cknowledge before me
this day of ��C, 20 by
�I i tcIC-1--
Name of person making statement
Personally Known OR Produced Identification_ _
Type of Identification
Produced F L
(Signature'fsf Notary Public- State of Florida )
� y Stephanie
Commission No. (S NOTARY
_STATE O
/v.,r ,w cfl1'flrn F
The fQrgging instrugpentwaaj cknowledge� before me
this a c l2� 201 b
ame of person :making statement
Personally Known OR Produced Identification,
Type of Identific"
Produced P L I)
Nnaturk of Notary Public- State of Florida )
ELIC Sion No. F F9157Va(phanie Moure
Lit k CTARY PUBLIC
U361 STATLE OF FLORI
Qn20 Cornm4- Fc957381
Rev. $/2/17
Ex.,"i; es 2/41202
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
XNGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. $/2/17