HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/04/2019 Permit Number:
LE
• Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _
PERMITTYPE: HVAC Change -out
PROPOSED IMPROVEMENT LOCATION:
Address: 9117 One Putt PI, Port St Lucie. FI 34986
Property Tax ID #: 333450101190000
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK.
existing 2 ton system with Goodman 2 ton 16.0 seer w/5kw heat
Mndels GSXC1 6024 & AVPTC25B
CONSTRUCTION INFORMATION:
Lot No.
Block No.
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: $ 5250.00
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name SUMIKO KURATO
Name:Tracy D Steele
Address: Apt 512 3-9-10
Company:Tracy D Steele Air Conditioning Inc
Address:2750 SW Edgarce St
City: Takaido Higashi, Japan State: _
Zip Code: Fax:
Phone No. 561-436-5027
City: Port St Lucie State:F1
Zip Code: 34953 Fax:
Phone No 772-336-2448
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 value of construction is $2500 or more, a KtLUKVtu rvouce of w...... ..Is,=y...•....•
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 1
Not Applicable I 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
Address:
City:
Zip: Phone:
Address:
Zip:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a perm¢ to ao ine worn dnu m>LducuL+. a
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
_ - ______ LENDER __ .m me nLrnnnnuc yetto IanTlt F nF COMMENCEMENT:'
nil„ YOUR LENDER wR wm wL .vno.. • v
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Signature of owner/ ea ss e/C actor as Agent for Owner
Signature o Conti .%to /Lice se Ho der
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LUCIE
COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me
The forgoing instru ent was acknowledged before me
20� by
this L{ day of �;Op , 20� by
this day of m 3 •
TRACY D STEELE
TRACY D STEELE
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known S OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
f
y1�
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
Com S 1)
Commissio
Notary Public Stets of Flontle
�M19 Notery Public State of FlaiOs
My Commission G 251853
REV FfRMW22120 2ZONING SUPERVISOR
My Co mission GG 251553
PLANS IffltpiresOM77�MRTLE NGROVE
REVIEW
REVIEW EVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2///IV