HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9-19-2019 Permit Number:
a
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
PERMIT TYPE: hvac change -Out
PROPOSED IMPROVEMENT LOCATION:
Address: Filfera Ct, Port St Lucie/FI 34952
Property Tax lD #: 342570302770004
Site Plan Name:
Project Name:
Commercial Residential X
Lot No._
Block No.
I ❑ETAILED DESCRIPTION OF WORK: i
Replace exist 4 ton package system with Goodman 4 ton 15.0 seer w/10kw heat, package unit
Model GPC15048
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
zechanical — Gas Tank _ Gas Piping _ Shutters Windows/Doors
Electric Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4500.00
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Anne Ross
Name: Tracy Steele
Address: 8479 Filifera Ct
Company: Tracy D Steele Air Conditioning Inc
City: Port St Lucie Stater I.
Zip Code: 34952 Fax:
Phone No. 772-877-3875
Address: 2750 SW Edgarce St
City: Port St Lucie State: FI
Zip Code: 34953 Fax:
Phone No 772-215-1974
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 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 Y UR NOTICE OF COMMENCEMENT."
bli� rl:Ae2
Signature of Owner/ Lesse /Contra or as Agent for Owner
Signature of Cont a ckLKicense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie
CO U NTY OF St Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 19 day of September 2p� by
this 19 day of September 20 by
Tracy D Steele
Tracy D Steele
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
'4 /(2
..L2
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission py Put*r 9tet��lide
Cammissio I
State al
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Daniel F Staceymv
Commission GG 251863
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, Daniel F Stacey 251653
REVIEWS
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REVIEW
REVIEW
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REVIEW
REVIEW
REVIEW i
DATE
RECEIVED
DATE
COMPLETED
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