HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1'171,2019 Permit Number:
J
Building Permit Application,
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7752) 462-1S53 Fax: (772) 462-1578 Commercial
PERMITTYPE: MECHANICAL
PROPOSED IMPROVEMENT LOCATION
Address: 12;114 NVV HARBOUR RIDGE BLVD
Property Tax ID #: 4426-600-0004-000-0
Site Alan Name:
Project Name: CHRISTOPHER AND VANE:SSA GUMM
DETAILED DESCRIPTION OF WORK:
HVAC LIKE FOR LIKE CHANGEOUT
3.5 TON 16 SEER 10 KW
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
Mechanical _ Gas Tank — Gas. Piping Shutters
_ Electric — Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 6438.00
OWNERAESSEE:
Name Christopher C Gumm Vanessa V Gumm
Sprinklers Generator
Sq. Ft. of f=irst Floor-
Address: 12314 Harbour Ridge BLVD
City: Palm City State:
Zip Code: 34990 Fax:
Phone No. 609-226-5678
E -Mail:
Residential X
Lot No. 3
Block No.
Windows/Doors
— Roof Pitch
Utilities. _ Sewer _ Septic Building Height:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Nage: FREDERICK MILLER
Company: MILLERS CENTRAL AIR
Address: 20 W INTERLAKE BLVD
City: LAKE PLACID State: FL
Zip Code: 33852 Fax:
Phone No 772-785-8080
E -Mail OFFICE@ MILLERSCENTRALAIR.COM
State or County License CAC058675
it vague or construction is 52504 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER
Name:
Address:
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:_
Zip:—
Phone:
Not Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation 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 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 lepder or an attorney before
commer)qing Work or recording your Notice of Commencement. /I 117
Owner/ Lessee/Contractor as Agent for Owner Sighture of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The f oing instr e. t was a knowled before me
this day of 20rL by
ILY
Name of person making statement.
Personal own—V OR Produced Identification
TVO of Identification
Produced
'{Sign'ature of NotaryPublic-State of Florida
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Name of person making statement.
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Commission No.
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