HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l J
Date: 04/10/2019 Permit Number: � U`"1 " ajL3
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE:
4 O1�Q 1 I1AP tOVEMENT LOCATION•
Address: 589 NETTLES BLVD. JENSEN BEACH FL 34957
Property Tax ID#. 4502-501-0775-000-4_ _—�— _ Lot No.
Site Plan Name: _ ______ Block No.
Project Name: KATSETOS CHANGE OUT
INET DESCRIPTION OF WORK:
INSTALLATION OF ONE 2.5 TON 14 SEER FRIGIDAIRE PACKAGE AIR CONDITIONING SYSTEM COMPLETE WITH FLECTRIC HEAT AND USING OZONE FRIENDLY 410A REFRIGERANT.
INFORMATION:
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: Sq. Ft. of First Floor:---
Cost of Construction: $ 3,900.00 Utilities: —Sewer _Septic Building Height:
OWNER/tEWE: CONTRACTOR: _-
Name James C Katsetos i Name:JUAN CRUZADO
Address:6156 Price Rd Company:JENSEN BEACH AIR & HEAT LLC
City: Loveland, OH State:^ Address:2092 SE HANFORD RD
Zip Code: 45140 Fax: City:_JENSEN BEACH V— State:FL
Phone No.513-261-4681 Zip Code: 34957 _ Fax:
E-Mail:CDKAT55@HOTMAIL.COM Phone No 772-334-3200
Fill in fee simple Title Holder on next page(if different E-Mail JENSENBEACHAC@GMAIL.COM
from the Owner listed above) State or County License CAC1818779
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.
SUPPLE MTAL CONSTRUCTION LIEN LAW INFORMATION':
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
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
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 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."
Signature f ner/Less Co atractor as Agent for Owner Sign at re oritractor/Licer Holder
STATE OF FLORIDA STATE OF FLORIDfft
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11COUNTY OF COUNTY OF �Irringinstr "a acknowled efore me The in in � as acknowled efore me
thisday of 120��by this id
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Name of perso making statement. Narn-e of person making statement.
Personally Known OR Produced Identification _ Personally Known_X____.OR Produced Identification
Type of Identification Tye of Identification
Produced Produced-------
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DATE
RECEIVED
DATE ----- - - �-_�.
COMPLETED
Rev.