HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST-'BE COMPLETED FOR"APPLICATION TO BE ACCEPTED
Date: 12/23/201,9 Permit Number:
- _ - - Building Permit Application RECEIVED
Planning.and Development Services DEC 2 3 2019
Building and Code Regulation Division -
2300 Virginia Avenue,Fort Pierce FL 34982
rtment
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Reside e(Depaeie nty
PERMIT TYPE: \A _
PROPOSED IMPROVEMENT LOCATION: '
Address: 1784 Walden Pond Dr
Property Tax ID#:.2303-211-0025-000-5 . Lot No.
Site Plan Name: Block No.
Project Name:
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DETAILED DESCRIPTION.OF WORK: .
Replacement of a 3-1/2 ton packaged unit`with 10 kW heat; like for like; 14 SEER '
CONSTRUCTION INFORMATION:
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:$ 3500 Utilities: —Sewer _Septic Building Height:
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OWNER/LESSEE: CONTRACTOR:
Ma Lou_I.ro cho James J Wauters...
Name Mary p_ Name:
Address:1784 Walden Pond DrCompany':Just Chillin' HVAC`LL-C_
City: Fort Pierce, FL 'State:_ Address:5422 NW.Cromey St
Zip Code: 34945,. Fax: City:.Port St. Lucie State:FL
Phone No.772-595-5357 Zip Code: 34986 Fax:
E-Mail: Phone No772-940-4373 ,. .
Fill in fee simple Title Holder on next page(if different E-Mailjustchillinair@hotmail.com
from the Owner listed above State or Count License CAC1819351 j
I Y
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 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 thepermit 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."
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Sy�' nature ofOwner/Lessee/Contractor as Agent for Owner Zignature of C ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA .. ,,
COUNTY OF C(� COUNTY OF S� Lq Cly
The for oing instrumen as acknowledged before me The forgoing instrum t was acknowledged before me
this_day of ,204 by this:�—�Iay of k4Q 0 20 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification C_
Produced Produced
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(Signature of L1Pub1111c-- te of Florid (Signatu o�Fj',gtp Publtt tail.State of Florida-Notary Pu is
ELLEN;22C
� HN Commiss °* r Commission # GG 2 �1Commission Nf Florioar Public ecY 0Fa�o• Y ommission Expires
mmissioG 270079 """`�� Octob®r 22, 2022
Octobe2 22
REVIEWS . SOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
lev.2/7/19