HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �1 �P�oZC �C-,( 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: Mechanical/HVAC Residential - Replacement System
PROPOSED INPROVEMENT LOCATION:
Address: 4010 AVENUE I , FORT PIERCE, FL 34947
Property Tax ID#: 2405-703-0053-000-3 Lot No. 19
Site Plan Name: Block No. 35
Project Name: A/C CHANGE OUT
DETAILED DESCRIPTION OF WORK:
Remove old AC system and install a new air conditioning system 2.5 Tons 16 SEERS with 8 kw electric heater
for residential property.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 1175 Sq. Ft. of First Floor:
Cost of Construction: $ 3769.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name CYNTHIA HAMILTON Name: Freddy Guillemi
Address: 4010 AVENUE I Company: Indoor Air Care, Inc.
City: FORT PIERCE State: FL Address: 1934 SW Biltmore St.
Zip Code: 34947 Fax: City: Port St. Lucie State: FL
Phone No. (772)971-4961 Zip Code: 34984 Fax:
E-Mail: cynthiahamilton34@yahoo.com Phone No (772)873-5003
Fill in fee simple Title Holder on next page ( if different E-Mail indooraircare@att.net
from the Owner listed above) State-,or County License CAC1816063
If value of construction is$2500 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:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: _A _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: Not Applicable
Name: 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 our Notice of Commencement.
Signature of Own ss r ctor as Agent for Owner Signature of ractor/L' se Holder
STATE OF FLORIDA STATE OF FL RIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6TH day of FEBRUARY 20 ICA by this 6TH day of FEBRUARY 20-n 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 Produced
Sig ature of Notary Public S lorida t)IZEiTESOLOMON ( natur of Notary Public St ridaSOLOMON
MY COMMISSION#GG211369 :/' •,� MY COMMISSION#GG211369
Commission No. GG211369 ( (� ES:APR 25,2022 Commission No. GG211369 rj�S:APR 25,2022
Bonded through 1st State Insurance °f B0 e t ugh 1st State Insurance
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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