HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10-16-19 Permit Number:
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: Mechancial
PROPOSED IMPROVEMENT LOCATION:
Address: 4180 N Hwy AllA Unit 4053
Property Tax ID #: 1423-506-0099-000-5
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Building Permit Application
Commercial X Residential
Like for Like AC Changeout 5 ton 14 seer with 10kw heat
[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 ^ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4,900.00
Sq. I"t. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Dave Halt
Name: Shyan Wojtczak
Address: 4180 N Hwy A1A Unit 405B
Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _
Zip Code: 34949 Fax:
Phone No. 863-557-0452
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
1t value of construction is $ZSOD 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.
SOPPLFMENTAL CONSTRUCT- 10N LIEN LAW INFO:RMATI0N:'
DESIGNER/ENGINEER: _ Not Applicable
Blame:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Andress:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 Horne Owners Association rules, bylaws nr 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 OWNEW 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 aVOwnerl Lessee/ ' trak for as Agent for Owner
Signature ofl antractor/License Heider
STATE OF FLORIDA . �f` jl �- V ef,
STATE OF FLORIDA ,
he C_-A e-J
COUNTY OF a'—)
COUNTY OE I yic-r
The forgoing instrument was acknowledged1�1 efore me
The forgoing instrument was acknowledged before me
this day of 2Ei by
this day ofG 26 by
' e
r
Name of person making statement.
Name of person making statement.
Personally Known " OR Produced Identification
Personally Known r— OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
,gnature f=Nc�aiilYcEl�a$K1D1#8��a i]7
(signature
f uFMWND
EXPIRES April 03, 2021
=' 'c MY COMMISSION q GG099903
Commission No. Seal
Commissior
EXPIRES Apr# Olfj
REVIEWS
FRONT
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( ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
BATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19