HomeMy WebLinkAboutBuilding Permit Application x
,All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9 " 12 - 19
Permit Number: 1�0 2A
RECEIVED
Building Permit Application
FEB 12 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMITTYPE:AC CHANGEOUT
PROPOSED;INPQVE'MENTLO.CATION: .
Address: 800 ANITA STREET
Property Tax ID#: 3403-332-0006-000-8 Lot No.03/36S/40E
Site Plan Name: Block No. 03/36SI40E
Project Name: 3 TON AC CHANGEOUT
DETAILED DESCRIPTION QFWORK
INSTALL 3 TON 16 SEER AIR CONDITIONING SYSTEM l
3 S .
r
CQRISTRUCTIQN INFORMATIQN
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: 1300 Sq. Ft. of First Floor:
Cost of Construction. $ 4500 Utilities: —Sewer _Septic Building Height:
OWNER%LESSEE CONTRACTOR
.x
Name _XCA h / L L Name:STEVE POREBA
Address:800 ANITA STREET Company:AIR XPERTS, INC
City: FORT PIERCE State: T-1. Address:PO BOX 1168
Zip Code: 3 4 G 9 Z. Fax: City: PALM CITY State:FL
/
Phone No. (T/ Z – 9 3 – / A0 Zip Code: 34990 Fax:
E-Mail: Phone No 7727775297
Fill in fee simple Title Holder on next page (if different E-MailAIRXPERTS@YAHOO.COM
from the Owner listed above) State or County License CAC1 818229
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 LI IU LAIN INFORMAT g
r
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable m
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _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 Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/Lice a Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFMARTIN COUNTY OFMARTIN
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 9 day of FEB 20_ by this 9 day of FEB ,20_ by
MELISSA ACKELL MELISSA ACKELL
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
Produce Produce
NOOTYPubitv state of Flortelik
Notary Public tate of Fk)dde Melissa Adcell
;� Melissa Ackell :�
c My Commission FF 234802 My commission FF 234602
ora Expires 06126/2019 or Expires 05/28/2019
(Signature o o ary ulic- a e o i a (Signature of Nota Pu Ii:-Stat
e
Commission No. S a ) Commission No:�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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