HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
11/13/2019 # (� E
Date: Permit Number: ! I o��
- --- Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X,
j PERMIT TYPE:AC Changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 5343 Galley Way Fort'Pierce, FL 34949
Property Tax ID#: 1410-502-0125-000-5 Lot No.
Site Plan Name: Block No.
Project Name: .
DETAILED DESCRIPTION,.OF WORK:
Replacement of a 2-.1/2 ton packaged unit with 7 kW heat; like for like; 14 SEER
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CONSTRUCTION INFORMATION:
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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: Sq. Ft.of First Floor:
Cost of Construction:$ 3282 Utilities: —Sewer _Septic Building Height:_
OWNER/LESSEE: CONTRACTOR:
Name Louise Bariault Name:James J Wauters
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Address:398 N Harbor City Blvd Ste A- Company:Just Chillin'HVA'&LLC
City=Melbourne, FL -- = State:_ Address 5422 NW Cromey St "_.
Zio,Code:,,,,- ,32935, r.Fa pity Port St:Lucie , �; State:FL
_.
Phone No'508 667 62- 8 Zip Code34986 ! } Fax;
- i i'i 7S F -fat ri _ `:r
E.Mail:° Phone Nd 772 940.4373:
1 Fill in fee simple Title,Holder on next page(if different E-Mailjustchillinair@hotmail.com
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from the Owner listed above) State or County License
CAC 1819351
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.
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SUPPLEMENTAL CON'STRUCTION 'LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not,Applicable MORTGAGE COMPANY: - _Not Applicable
Name: Name:
Address: Address:
City: State: City: Stater
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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."
Sig ature of 0 ner/Lessee/Contractor as Agent for Owner Signature of tontract&/License Holder
STATE OF FLORIDA' STATE OF FLORIDA p
'COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing�instrument was acknowledged before me
this day of 120 by this day of .20_ by
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Name of per n making statement. Name of perton making statement.
Personally Known - OR Produced Identification.. Personally.Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced.
_41gnature of Notary'Public- to of Florida) (Signature of Notary Public-St to of Florida)
Commission No. :'i+?"'!' •: 'LASHAHNAJNffl*'MAHMING Commission No :':r •�g'•; -ASHAHNAINGRVWMING "
MY COMMISSION 6 GG 275060 =,; :# COMMISSION#GG 275060'
EXPIRES:DBOBrobe.20i 2022 bar EXPIRES:Decam
rzj�Kw $)ndodThtallotary Pu ftUndamfters' dedThtuNotaryPublic nderwi e
REVIEWS ' IR. PLANS VE VE
COUNTER REVIEW.. REVIEW REVIEW REVIEW, REVIEW REVIEW,
DATE
RECEIVED
DATE
COMPLETED
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