HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02/22/2019
Permit Number:
r�
COUNTY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone. (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential X
PERMITTYPE: HVAC CHANGE OUT
LPOPQSED IIIfIPROVEMENT LOCATION:
Address: 209 OAK LN
Property Tax ID #: 3419501009550005
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace existing 3 ton system with Goodman 3 ton 16.0 seer w/8kw heat
Models GSX16S36 & ASPT 37C
CONSTRUCTION INFORMATION:
Lot No._
Block No.
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank —Gas Piping
_ Shutters _ Windows/Doors
— Electric _ Plumbing T Sprinklers
—Generator _ Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ 3500.00 Utilities:
— Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DOROTHY ROULO
Name:
Address: 209 OAK LN
Company:TRACY D STEELE AIR COND. INC.
City: POORT ST LUCIE State:
Address: 27 SW EDGARCE ST
_
Zip Code: 34952 Fax:
City: PORT ST LUCIE State: FL
Phone No. 804-400-4708
Zip Code: 34953 Fax:
E -Mail:
Phone No 772-215-1974
Fill in fee simple Title Holder on next page ( if different
E -Mail tdsac@aol.com
from the Owner listed above)
State or County License CAC035553
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:
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
§t—at e:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip; Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:_ ___-
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 JOB SITE BEFORE THE FIRST INSPECTION, IF YOU INTEND 70 OBTAIN FINANCING, CONSULT
WITH YOUR L DER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of
STATE OF FLORIDA
COUNTY OFSTLUCIE
as Agent for Owner I Signature
The forgoing instrument was acknowledged before me
this 22 day of >~EB. . 20_ by
TRACY D STEELE
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Com miss n f —A— — — r — — cState o1 fio(; a
* Dan elf Stacey
My Commission GG 251653
REV
DATE
RECEIVED
DATE
COMPLETED
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STATE OF FLORJDA,
COUNTY OF
Holder
The forgoing instrument was acknowledged before me
this 22 day of FEB. 20� by
TRACY D STEELE
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature o Notary Public -State of Florida )
Com Notary eftc stats of Fbrift
r acey
riTt; My Commission GG 251053
7coNTER REVIEW �RIEWOR
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