HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/29/2019 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 TYPE:
PROPOSED INPROVEMENT LOCATION:
or1,1YP«. 410 Willows Avenue, Port St. Lucie, FL 34952
Property Tax ID #: 3419-510-0197-000-8
Site Plan Name:
Project Name: AC CHANGE OUT
Lot No. 8
Block No. 17
DETAILED DESCRIPTION OF WORK:
Remove old AC system and install a new air conditioning system 3 Tons 16 SEER with 8 KW Electric Heater
for residential property.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
X Mechanical Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 1153
Cost of Construction: $ 4000
Sq. Ft. of First Floor: _
Utilities: —Sewer —Septic
_ Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Shiela Soler
Name: Freddy Guillemi
Address: 410 Willows Avenue
Company: Indoor Air Care, Inc.
City: Port St. Lucie State: VL
Zip Code: 34952 Fax:
Phone No. (772) 631-5633
Address: 1934 SW Biltmore St.
City: Port St. Lucie State: FL
Zip Code: 34984 Fax:
Phone No (772)873-5003
E -Mail: escesswithincontrolpp@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail indooraircare@att.net
State.or County License CAC1816063
If value of construction is 52500 or more, a RELURUEU Notice of l.ommencement rs requrreu.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: X Not Applicable
Name: —
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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
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Signatur,�%% ner/ Cesse Co tractor as Agent for Owner
Signat r ont r ' e e Holder
STATE46 FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie _
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 29th day of January 20 19 by
this 29th day of January 20J_J by
Lizette Solomon
Lizette Solomon
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
xx
Produced
ature tar Public-
( y
t IoridaUZETTESOLOMON
(ignat a of Notary Public -St rids ) LIZETTE SOLOMON
= ~,1� MY COMMISSION #GG211369
:°�""Y"0�� MY COMMISSION #GG211369
Commission No. GG211369
(WWI S: APR 25, 2022
Commission No. GG211369 ,,( ' S: APR 25, 2022
Bolded thr ugh tet State Insurance
P° Bonded through 1st State Insurance
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Rev. 9/26/18