HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7-28-19 Permit Number:
COUNTY
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
PERMIT TYPE: Mechancial
PROPOSED IMPROVEMENT LOCATION:
Address: 3220 Hatcher St
Property Tax ID #: 2429-601-0018-000-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 4 ton 14 seer with 10 kw
CONSTRUCTION INFORMATION:
Commercial Residential x
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric —Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ $3,800.00
Sprinklers _ Generator
Sq. Ft. of First Floor: _
Lot No._
Block No.
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height-
OWNER/LESSEE:
CONTRACTOR:
Name Travis & Patricia Williams
Name: Shyan Wojtczak
Address: 3220 Hatcher St.
Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _
Zip Code: 34981 Fax:
Phone No. 772-370-4298
Address: 6903 Cabana Lane
City: Fart Pierce State: FL
Zip Code. 34951 Fax: 772-801-5398
Phone No 772-634-0491
E-Mail:
Fill in fee simple Title Holder on nerd 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: 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."
LU 1.«
Signature Owner/ Lessee ontractor as Agent for Owner I Signature f Contractor/Lic n alder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF a , L_L; C, i f� COUNTY OF _ J- I— t -;(' ; (?_
The Mg inst nt was acknowledge before me
this ay of U 20_tj by
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Name ofl5erson making sta`Pement.
Personally Known OR Produced Identification
Type of (dent'f'tion ,
Produced I
(Signaturb oTNotary Public- State of Florida )
Commission No. F � 3� I
REVIEWS FRONT. I ZONING
COUNTER I REVIEW
DATE
RECEIVED
DATE
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The Twy
instruMprit as acknowledgeAbefore me
this of 0 20 by
Name of pers6n making staterrient.
Personally Known OR Produced Identification_
Type of Identific ti
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Stephanie kWature df Notary Public- State of Florida ' o NOTARY F
NOTARY tJBLIC / (�" 3 / �STATEOF
STATE OFOT ,Upssion No. I I y0omnt# FI
Comm# F 95738, • �C� tsi� Expires 21
SUPERVISOR I PLANS VEGETATION I SEA TURTLE I MANGROVE
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