HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1130119 Permit Number:
- 01�
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:Mechancial
PROPOSED INPROVEMENTLOCATION:
Address: 4201 Redwood Dr
Property Tax ID #: 1313-502-0108-000-2
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Building Permit Application
Commercial Residential X
AC Changeout like for like 4 ton 16 seer with 1 Ow heat
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank _ Gas Piping — Shutters
Electric
Total Sq. Ft of Construction: _
Cost of Construction: $ 3,60C
Plumbing
_ Sprinklers — Generator
Sq. Ft. of First Floor: _
Lot No.
Block No.
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name John & Susan Baessell
Name:Shyan Wojtczak
Address: 4201 Redwood Dr
Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce State:
Zip Code: 34951 Fax:
Phone No. 305-331-5305
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.
If value of MVAC is $7,500 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:
DESIGNERIENGINEER: 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.
Signatur f Owner/ Les ontractor as Agent for Owner
Signature o ontractor/Li a Holder
STATE OF FLORIDA
COUNTY OF e
STATE OF FLORIDA
COUNTY VJ�E'►2
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OF . jGt_
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledgef, before me
this _LtJ day of\' (Alf 20)q by
this IU day of 20 .by
Gr'1 LJ2 f+C_Zf_-
(-D iC__
Name of person making statement.
-
Name of pe son making statement.
Personally Known OR Produced Identification V1
Personally Known OR Produced Identificationr
Type of Identification
Type of Identificatio
Produced h -D
Produced F- £7�—.
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{Signature No ry P lic- State of F ria
ignature of otary Pu ic- tate of
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Commission No.1516, IZ5 'Sed"Pubic-StaleuFFlorida
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DATE
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DATE
COMPLETED
Kev. 1/9/2019