HomeMy WebLinkAboutSLC SHULTZ PERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/16/2019 Permit Number:
i
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMITTYPE: hvac
PROPOSED IMPROVEMENT LOCATION:
Address: 1741 MALLARD CT
Property Tax ID #: 340950300190004
Site Plan Name:
Project Name:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Replace existing 1.5 & 4 ton systems with Goodman 1.5 16.0 seer w15kw & 4 ton 14.5 seer w/10kw
Models GSX16018, GSX16048, ASPT25B & APTC59C
CONSTRUCTION INFORMATION: i
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: $ 8325.00 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
NameJEFF SHULTZ
Name:
Address: 1741 MALLARD CT
Company:TRACY D STEELE AIR COND. INC.
City: FT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 772-201-4802
Address: 2750 SW EDGARCE ST
City: PORT ST LUCIE State: FL
Zip Code: 34953 Fax:
Phone No 772-215-1974
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailtdsac@aol.com
State or County LicenseCAC035553
it vawe or construction is �Z5U0 or more, a RECORDED Notice of Commencement is required.
If value of FIVAC 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:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _ _ Not Applicable
Name:
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 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. 1F YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR,NOTICE OF COMMENCEMENT."
fiAA
Signature of Owner/ ess eJCo tracto Agent for Owner
Signature of ContrhorJLic nse Holder
STATE OF FLORID .-
COUNTY OF— )j�5
STATE OF FLOR A
COUNTY OF 7
The forgoing instrument was acknowledged before me
this 1L day of ,44� 20J� by
The forgoing instru was acknowledged before me
this & day of 2p� by
c �
Name of person making statement.
Name of person making statement.
Personally Known _V-' OR Produced Identification
Personally Known II OR Produced Identification
Type of Identification
Type of Identification
Produced
Produc d
FWrift
Notary Public State of pWr� Daniel F Stace(Signature
t3dsj5s
R,iRF]
(Signature of Nota a �G 251653
of M1� / 22
CommissioCommission
No. e
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1