HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED
Date: 9-25-19
•
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: 4180 N Highway A1A, Unit 404B
Property Tax I D #: 1423-506-0098-000-8
Site Plan Name:
Project Name:
I APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
DETAILED DESCRIPTION OF WORK:
Like for like AC change out 3.5 ton 14 seer 10kw
CONSTRUCTION INFORMATION:
Commercial X Residential
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: $ $4,100.00
Sprinklers _ Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Pawel Luckiewicz
Name: Shyan Wojtczak
Address:413 McKean Dr
Company: Cool Air Solutions of Florida, Inc.
City: Wexford, PA State: _
Zip Code- 15090 Fax:
Phone No. -
Address: 6903 Cabana Lane
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No 772-634-0491
E-Mail:
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 $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_MNSTRUCTION LIEN LAIN INFORMATION:
DESIGNERJENGINEER: _ 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 Countt,y� makes no representation that is granting a permit will authorize the permit holder to build the subject structure
s thich 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: rooms 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'."
Signature of'Owner/ Lessee/Q,ohtca±or as Agent for Owner
Signature of1Evntractor/Ucenae Heider
STATE OF FLORIDA
STATE OF FLORiDA
COUNTY OF S+ Luc,
r.
COUNTY OF L C ( P
I
The for Ding instrument was acknowiedged before me
this 55 day of_jg2j _ Z0� by
The for Ding instrument was acknowledged before me
thisj_day of J ciaL 20by
2 -q
Name of person making statement.
Name of person making statement.
Personally Known "'OR Produced Identification
Personally Known `-- OR Produced Identification
Type of Identification
Produced
Type of Identification
Produced
gnature fiNo
(Signature
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"' EXPIRES April 03, 2021
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Commission Na. Seal
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EXPIRES April 0;('M4
REVIEWS
FRONT
ZONING
SUPERVISOR PLANS I
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
I
DATE
COMPLETED
ev. 11/114