HomeMy WebLinkAboutSLC YAFFEYAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07/31/2019
Wi
Plonning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
PERMIT TYPE: HVAC Change -out
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential X
Address: 7684 Wyldwood Way, Port St Lucie 34984
Property Tax ID #; I.e.o. Lot No.
Site Plan Name:
Project Name:
Block No.
I DETAILED DESCRIPTION OF WORK: I
Replace existing 1.5 ton system with-,
Ruud 1.5 ton 16.0 seer w/5kw heat
Models RA1618 & RH 1 T2417
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4000.00
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ana YafFey
Name: Tracy Steele
Address: 7684 Wyldwood Way
Company: Tracy D Steele Air Conditioning Inc
City: Port St Lucie State:
Zip Code: 34986 Fax:
Phone No. 786-547-4705
Address:2750 SW Edgarce St
City: Port St Lucie State: FI
Zip Code: 34953 Fax:
Phone No772-215-1974
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail tdsac@aol.com
State or County License CAC035553
If valve 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 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
swh ch is in tructure. Please consult any applicable
Hlome owners Associatioclan and rules,
your deaws or ed for any restrictions venants at which may aor pply obit such
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 OTICE OF COMMENCEMENT."
Signature of Owner/ Le see/ a ractor as Agent for Owner Signature of Contrackor/Liciwsle Holder
STATE OF FLORIDA _
COUNTY OF )z= "
The forgoing instrument was acknowledged before me
this) 1 day of 20,a by
Name of peFs-ft making statement.
Personally Known / OR Produced Identification
Type of identification
Produced
(Signature of Notary Public- State of Florida )
Commission No.
Notary Public Staffs of Florida
aMy Commission 251653
REVIEWS �d� Za2 SUPE
DATE
RECEIVED
DATE
COMPLETED
STATE OF FLORID
COUNTY OF ;r -
The forgoing instrument was acknowledged before me
this day of 'J C1L1 2041� by
Name of personAaking statement.
Personally Known r� OR Produced Identification
Type of identification
Produced
(Signature of Notary Public- State of Florida )
Commission
Notary Public State of Flori
fuSy ommisition GG 25165
PLANS V NExa>4L�i2T�RTLE a
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