HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/2912019
Permit Number.
COUNTY
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V
PERMIT TYPE: MECHANICAL
PROPOSED IMPROVEMENT LOCATION: --
Address: 4214 AVENUE Q
Property Tax ID #: 2406-114-0010-000-5
Site Pian Name:
Project Name: WILLIAM KENNEDY
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE HVAC CHANGE OUT 5 TON 15.0 SEER 10 KW
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
Lot No..
GI531I.TOW
_Mechanical _ Gas Tank —Gas Piping _ Shutters — Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 7230.00
Sq. Ft. of First Floor:
Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WILLIAM KENNEDY
Name: FREDERICK MILLER
Address: 4214 AVENUE Q
Company: MILLERS CENTRAL AIR, INC
City: FT PIERCE State: _
Address: 20 W INTERLAKE BLVD
City: LAKE PLACID State: FL
Zip Code: 33497 Fax:
Phone No. 772-318-5128
Zip Code: 33852 Fax:
E -Mail:
Phone No 772-785-8080
Fill in fee simple Title Holder on next page I if different
E -Mail OFFICE r@MILLERSCENTRALAIR.COM
from the Owner listed above)
State or County License CAC058675
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:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
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 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, 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. I If YOU INTEND TO OBTAIN FINANCING, CONSULT
W131H YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YWJR NOTICE OF COMMENCEMENT."
of Owner/ Lessee/Contractor as Agent for Owner
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Name of person making statement.
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DATE
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Contractor/License Holder
STATE OF FLORIDA j
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this"! day of 1(X/ 120 -1 by
Name of person making statement.
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