HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: August1 ,2019 . Permit Number: 9 A O
RECEIVE[
Building Permit Application
AUG 14 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:AC Change out
PROPOSED IMPROVEMENT LOCATION:
Address: 1917 N 44th St.
Property Tax ID#: 2406-501-0007-000-9 Lot N0.7
Site Plan Name: Jerry Williams Block No. 1
Project Name: AC Change out
DETAILED DESCRIPTION OF WORK:
Exact AIC Change out of a 3.5 Ton Goodman 14.5 seer Split sytem AH-ASPT49C14A, Condenser-GSX16S421A
Z KW
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
Y` 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:$ 3500.00 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE; CONTRACTOR,
NameJerry,Tonnelia and Elnora Williams Name:Stephan S Buckley
Address:1719 N 44th St Company:AC All Stars
City: Ft. Pierce State:FL Address:21621 Magdalena Ter
Zip Code: 34947 Fax: City: Boca Raton State:FL
Phone No.772-462-5248 Zip Code: 33433 Fax: 561-367-3444
E-Mail: Phone No561-702-1943
Fill in fee simple Title Holder on next page(if different E-Mailsfaa4995@aol.com
from the Owner listed above) State or County License CAC1 817509
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.7-
Sigk t re of Own /Lessee/Contractor as Agent for Owner Sign Contractor/Li se Hol e
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Palm Beach COUNTY OF Palm Beach
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this.7 day of August .20_ft by this 7 day of August ,201C� by
Jerry Williams Stephan S Bucidey
Name of person making statement. Name of person making statement.
Personally Known OR Produced IdeRifiaatibn1j,,7_ Personally Known x OR Produced 00htif 6tj?P
Type of Identification ���.( JAt�(���iType of IdentificationiVF
ProducedFLoL �� Q-; N �.� Produced �� - 1� n("
Off.
4�'t.% to
o —
ign ture o o ry Public-State of 68s r T (Sigr f Notary Public-St&��f$'t
Commission No. ccosessa `' , Ike OR10P��`��` Commission No. GG068568 '�,//',C� {, 1':'1`0``�.`
�111 I 1111�� 11111IIUVIif11AP1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19