HomeMy WebLinkAboutPermit Application for 193 Tumblin Kling RdAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2-27-19
MR
coup
F 1 rn I
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34582
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 193 Tumblin Kling Rd
Property Tax ID #: 2434-801-0012-040-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
AC Changeout 2.5 ton 14 seer with 8kw heat
CONSTRUCTION INFORMATION:
Permit Number:
Building Permit Application
Commercial Residential X
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 _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 3,400
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
QWNER/LESSEE:
CONTRACTOR:
Name Tom Weisser
Name:Shyan Wojtczak
Addressr193.Tgmblin Kling Rd. ,.Corripar<y:COQI
Air.Solutions of Florida, Inc.
City: Fort Pierce State: _
Zip Code: 34982-6837 Fax:
Phone No. 772-466-9022
Address:6903 Cabana Lane
City: Fort Pierce State: FL
Zip Code: 34951 ;Fax: 772-801-5398
Phone No 772-634-0491
E -Mail coolairsol@gaii.com
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License GAC# 1819009
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: _ 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.
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 thepermit 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, l 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 TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
nNx'-� t�
for Owner
Signature Contractor/
Signatur of Owner/ LeQ0426ntractor as Agent
ol c n alder
STATE OF FLORIDA_.
COUNTY OF _4_\Cj{�:� #21_IvC-r
STATE OF FLORIDA
COUNTY OF -L �iCr IZi
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this a_1 day of FC. t ucT 20 19 by
this day of � ]fyc �t 1 ZO_L by
—r=
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ODLL CSC- K_
Name o person making statement.
Personally Known OR Produced Identification V_
Name of person making statement.
Personally Known OR Produced Identification
Type of Identificatio
Type of Identification
Produced a ELLE L HARRIS
Producedt ANIELLE L HARRIS
_17jFNotary Public - State of Florida
Commission # GG 256950
otary PublicState of Florida
Commission 11 GG 25695D
Mic-_Stagte�_ofTlorid—a)
OF
My Comm. Expires Sep 10, 2021
y Comm. Expires Sep 10, 2022
(Si nature of Notary i - a e o ori a
(Sign re of No/t'aarry Pu(
Commission No. as � (Seal)
Commission Nod —10-Y� ( �D (Seal)
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Rev. 2/7/3.9