HomeMy WebLinkAboutBuilding Permit Application II
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
-- - Building Permit Application
Planning and Development ServicesDepartment
permitting 'nty
Building and Code Regulation Division St uo,e Co
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:AC Changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 3441 Southern Pines Dr. Fort Pierce, FL 34982
Property Tax ID#: 2428-702-0061-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
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DETAILED DESCRIPTION OF WORK:
Changeout of a 3.5 ton split system with 10 kW heat 15 56p
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FCONSTRUCTION INFORMATION:
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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:$ 3850 Utilities: —Sewer _Septic Building Height:
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OWNER/LESSEE: CONTRACTOR:
Name Anthony Ivins Name:James J Wauters
Address:PO Box 452898 Company:Just Chillin'HVAC LLC
City: Los Angeles, CA State:_ Address:5422 NW Cromey St
Zip Code: 90045 Fax: City: Port St. Lucie State:FL
Phone No.772-871-2727 Zip Code: 34986 Fax:
E-Mail: Phone No 772-940-4373
Fill in fee simple Title Holder on next page(if different E-Mail justchillinair@hotmail.com
from the Owner listed above) State or County License CAC1819351
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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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: A�Alj Name:
Address Address:
City: State: City: State: I
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 siuch
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."
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Sigfiature of O ner/Lessee/Contractor as Agent for Owner Signature ofContractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF � � (I(��� COUNTY OF l �I
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The forgoing instr ent was acknowledged before me The for oing instru nt as acknowledged before me
this ay of 20 by this ay of 201by
0j"e s '�CAWX3 W aUl�e6
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
ProducedProduced
(Signature of Notary P ,Ir (Signature of Notary Public-State of Florida)
ELLEN VAUGHN
_State ofj F
Commission No. *= ComnliSs�s��ida-Notary Public Commission .�������� N VAUGHN
n #GG 2700 :o a —EfLE
OF F �` MY Commission Expires9 =; �zState of Florida-Notary Public
ontm—
OFF M Comm'i$ �q Ex 0079
REVIEWS FRONT ZONING SUPE PLANS BEt�tT�l �L` 02
Ifft ROVE
COUNTER REVIEW REVIEW REVIEW R EW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
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