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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c�
Date: `0\,d\\ Permit Number:
I J _
RECEIVED
AUG 0 ?019
- - Building Permit Application
Planning and Development Services , Zycie_Count. f3er�itt�ng
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE:AC Changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 10819 Orange Ave Fort Pierce,FL 34945
Property Tax ID#: 2309-412-0002-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Replacement of a 4 ton split system with 10 kW heat;like for like; 14 SEER
[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 _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of.Construction:$ 4118 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Lori Wuchte Name:James J Wauters
Address:10799 Orange Ave Company:Just Chillin'HVAC LLC
City: Fort Pierce, FL State:_ Address:5422 NW Cromey'St
Zip Code: 34945 Fax: City: Port St. Lucie State:FL
Phone No.772-370-6128 Zip Code: .34986 Fax:
E-Mail: Phone No 772-940-4373
Fill in fee simple Title Holder on next page(if different E-Mailjustchillinair@hotmail.com
from the Owner listed above) State or County License CAC1819351
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 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:'
Sig ature of Ow er/Lessee/Contractor as Agent for Owner Si ature of CoFftractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 6r. Luc:%� COUNTY OF 5V
Theforgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this V day ofO, J 20 k1 by this cX—day of 2d1l by
�gw.c.b 1Q,0.-6 -5 1A41..--6 A-�t3
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
Produced ��- O�' Produced �- L
(Signature of Notaryublic-State of Florida) (Signature of No ' ; ic-Stai o );Gp7L tc
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Commission No. d7'�� h � }�ON�o?202 Commission N011' .'�'. <_ a P�REy�yotzN�9 ca�
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