HomeMy WebLinkAboutPermit Application for 2407 Kelly CtAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2-27-19 Permit Number:
COUNTY
F i n Q. 1 i
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: Mechanical
PROPOSED IMPROVEMENT LOCATION;
Address: 2407 Kelly Ct
Property flax ID #: 2421-601--0031-000-0
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
AC Changeout 2.5 ton 14 seer with 8kw heat
CONSTRUCTION INFORMATION:
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 _ Generator — Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2,600
Sq. Ft. of First Floor:
Utilities: Sewer . _ Septic Building Height:
OWER/LESSEE:
CONTRACTOR:
Name Randall Minor
Name:Shyan Wojtczak
Ad6e55:4720 Kirby LQQp,Rd,.,,.,
Company:Cool Air Solution&& 6rida, Inc.
City. Fort Pierce State:
Zip Code: 34981-5344 Fax:
Phone No. 772-201-6547
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 CAC# 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.
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 A55OC12tion 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 TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signatur of Owner/ Les e / ntractor as Agent for Owner Signature -df Contractor/!_Holder
STATE OF FLORIDA -
COUNTY OF
The forgoing instrument was acknowledged before me
ti Fkday 20A by
Name o erson making statement. ,
Personally Known OR Produced identification "lam
Type of Identification
Produc dPe<- r DANIELLE L HARRIS
Notary Public - State of Floridoi
Commission # GG 256450 r
My Comm. Expires Sep 10, 20i:
{Signature of Notary Public- State of Florida }
Commission No`s q5 (Seal)
STATE OF FLORIDA.
COUNTY
The forgoing instrument was acknowledged before me
this day of 20_ by
1C
Name o person making statement.
Personally Known OR Produced Identificatio
Type of Identificatio
NIELU L HARRIS
Notary Public - State of Florida
Commission # GG 256950
My Comm. Expires Sep 10, 2022
(Signature of Notary u'_licc---Slate of Florida )
Commission NoGGD t S (Seal)
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DATE
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DATE
COMPLETED
GV. 2/7/19