HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/3/19
COUNTY
F
L O
R
n A
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: 21 FLORES WAY
Property Tax ID #: 3427-111-0002-000-5
Site Plan Name:
Project Name: SHARON ANDERSON
I DETAILED DESCRIPTION OF WORK:
Permit Number:
Building Permit Application
Commercial Residential X
A/C CHANGE OUT OF A 3 TON YORK PACKAGE UNIT WITH A 10 KW 14 SEER
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit — check all that apply:
X Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:,
Cost of Construction: $ 4600
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name SHARON ANDERSON
Name: GRETA B. SMITH
Address: 21 FLORES WAY
Company: ALL YEAR COOLING & HEATING
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax:
Phone No.
Address: 1345 NE 4TH AVE
City: FORT LAUDERDALE State: FL
Zip Code: 33304 Fax:
Phone No 954-566-4644
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail PERMITS@ALLYEARAC.COM
State or County License CAC058160
IT value oT construction Is ,>LSUU or more, a KtCUKUtD 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
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:
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."
llku'Lm�
Signat6e of 0 ner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SAINT LUCIE
COUNTY OF 6RO-RD
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 3 day of JULY 20yq by
this 3 day of JULY 20 19 by
SHARON ANDERSON
GRETA B. SMITH
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification x
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced DRIVER'S LICENSE
Produced
/
! V ,04
(Signature of Nota/1Iry' Public
U =p".9y PV�^ Notary Public State of Florida
Commission No. GG 040158 RRb James Buckley
o` M ission GG 040158
OF Wok Expires 10/19/2020
Signature of Notar Publi a�
8s�+ (Ar! IY ublic State of Florida
GC 040158 Q Robert James Euckley
ommission No. �o My g6r®eil�ion GG 040158
oFFLOQ Expires 10/19/2020
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