HomeMy WebLinkAboutBuilding Permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8-13-19 Permit Number:
•
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 5706 Killarney Ave
Property Tax ID #: 1301-613-0035-000-3
Site Plan Name:
Project Name:
Building Permit Application
Commercial Residential X
DETAILED DESCRIPTION OF WORK:
Like for Like AC changeout 4 ton 14 seer with 10 kw heat
CONSTRUCTION INFORMATION:
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: $ $3,375.00
w Sprinklers — Generator
Sq. Ft. of First Floor: _
Lot No. —
Block No.
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Logan Green
Name: Shyan Wojtczak
Address: 5706 Killarney Ave
Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State:
Zip Code: 34951 Fax:
Phone No.772-766-9598
Address: 6903 Cabana Lane
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No 772-634-0491
i
E-Mail:logangreen630@mail.com
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 52500 or more, a RECORDED Notice at [:ommencement is requirea.
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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"
s r�
` i C
Signature a0wnerf Lessee/ ' tactor as Agent for Owner
Signature of C-ontractor%Lice 1-Wder
STATE OF FLORIDA :
COUNTY OF LQ Ci
STATE OF FLORIDA
COUNTY OF LU C i E
The forgoing instrument was acknowledged before me
this �Ayay of � u,5S . 20� by
The forgoing instrument was acknowledged before me
this r 3oday of AvCj U .�-+ ! Eby
(,
ct 1/
k20
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
Produced
R-4D
.. : wl.At
rgnature c f-'14o �c�i I1SAIBSiRDllti �OI38 �7
Y ,!4•; EXPIRES April 03. 2021
Commission No. Seal
(Signature
Commission
i
i
4. 'u
MY COMMISSION # GGUB9907
i ,• EXPIRi=S ApA 0:000
REVIEWS
� FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
_
DATE
COMPLETED
ev. 1