HomeMy WebLinkAboutSLC PERMIT MONASTALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 211 9/2 01 8 Permit Number:
•
Building Permit Application
Planning and Development. Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 9120 SHORT CHIP CIR
Legal Description:
Property Tax ID #: 333450101990004
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: I
Replace existing 5 ton heat pump with
Ruud 5 ton 15 seer heat pump w16kw heat
Models RP1560 & RH1T60
CONSTRUCTION INFORMATION:
Additional work toa nertormed under this permit — check all appy:
12]HVAC Gas Tank []Gas Piping _ Shutters E]Windows%Doors
Electric El Plumbing Sprinklers Generator n Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4800.00
Sq. Ft. of First Floor:
Utilities: Sewer []Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name Charles Monast
Name:
Address:9120 Short Chip Cir
Company: TRACY D STEELE AIR COND. INC.
City: Port St Lucie State: FI
Zip Code: 34986 Fax:
Phone No. 772-801-5543
Address: 2750 SW EDGARCE ST
City: PORT ST LUCIE State: FL
Zip Code: 34953 Fax. 772/336/4171
Phone No. 7721336/2448
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed alcove)
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.
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:
Add ress: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 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. !fn
Signature of Own
STATE OF FLORIDA
COUNTY OF ST LUCIE
as Agent for Owner
The forgoing instrument was acknowledged before me
this 19 day of DECEMBER , 201Y by
TRACY D STEELE
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission N�rRb%
I
Notary Public Stele of Flaride Daniel F Stacey
Signature of CoAtractor i nse Holder
STATE OF FLORIDA
COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me
this 19 day of DECEMBER , 20// by
TRACY D STL'EELE
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
.�.
(Signature of Notary Public- State of Florida )
Commission
'rf
7tJ Notary Public State of Florida
Daniel F Stacey
My° mi i
Expire QaJ22f2022�TI
Expires
a
08/2212022
REVIEWS N
RVISOR
PLANS
V
GROVE
R I W
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17