HomeMy WebLinkAboutPermit Application for 4160 N Hwy A1A Unit 707AAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7-18-19 Permit Number:
MEN
COUNTY
F 1 n R 1 r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Mechancial
PROPOSED IMPROVEMENT LOCATION:
Address: 4160 N Hwy Al #707A
Property Tax ID #: 1423-506-0042-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 5 ton14 seer with 1 OKW
CONSTRUCTION INFORMATION:
Commercial X Residential
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: $ 4900
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameCharles & Judene Hansen
Name:Shyan Wojtczak
Address: 5114 SW BlueDaze Way
Company:Cool Air Solutions of Florida, Inc.
City: Palm City, FL State:
Zip Code: 34990-8640 Fax:
Phone No. 772-209-0488
Address: 6903 Cabana Lane
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No 772-634-0491
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail coolairsol@gmail.com
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 LAIN 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: i 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 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."
SignatureOwner/ L� e�G��✓ n ractor as Agent for Owner Signature Contractor/Lic n older
STATE OF FLORIDA STATE OF FLORID
COUNTY OF _U(' 1 COUNTY OF + �t _)0 , C,
The fofgping instrument was acknowledgc¢,before me
this ay of U} 20 by
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Name o erson making sta ement.
Personally Known OR Produced Identification X
Type of Ident'fii tion
Produced Y l_ 0 l _
(Signaturb of Notary Public- State of Florida �t y `Stephanie
F�% J / t
Commission Na. %J U l ( o NOTARYSTATE OI
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The Tw- instru€�nt as acknowledge before me
thisy of C",20M by
Name of pe n making statement.
Personally Known OR Produced Identification_ _
Type of ldentific t� C_ L
Produced
ure df Notary Public- State of Florida
NOTARY
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