HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/14/2019 Permit Number:
•
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
Commercial Residential X
PERMITTYPE:AIR CONDITIONING EXACT CHANGE OUT
PROPOSED IMPROVEMENT LOCATION:
Address: , - PINE LAKES BLVD
Property Tax ID #: 3422-596-0007-000-6 Lot No.
Site Plan Name: PINE SUMMIT Block No.
Project Name:
DETAILED DESCRIPTION OF WORK.
EXACT CHANGE OUT OF 2 TON A/C UNIT
iGOODMAN.. 14 SEER
5KW
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
1,-Mechanical Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ d`413," rJ 0
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name RORY RAMCHARAN
Name:RORY RAMCHARAN
Address:6810 COUNTRY PLACE RD
Company:AIR PLUS OF SOUTH FLORIDA INC
City: WEST PALM BEACH State: _
Zip Code: 33411 Fax:561-557-7468
Phone No.561-313-0490
Address:6810 COUNTRY PLACE RD
City: WEST PALM BEACH State: FL
Zip Code: 33411 Fax: 561-557-7468
Phone No561-313-0490
E-Mail:INFO@AIRPLUSFL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail INFO@AIRPLUSFL.COM
State or County LicenseCAC1815149
If value of construction is 52500 or more, a RECORDED Notice of Commencement is regwreo.
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. T Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY
Name:_
Address:
City:_
Zip:
Phone:
Not Applicable
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 Yntio It FNnFp inR AN ArrO€rNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
Signature of C?wnW Lessee/Contractor as Agent for Owner
Signatu e o ntractor/License holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFeALMsEAcH
COUNTY OFPALM BEACH
The forgoing instrument was acknowledged before me
The f Ding instrument was acknowledge! fore me
this � day of�'�'t� Lka fT 2 by
this day of , C�ItlA Gi.� L I , 20z
D � (A+A-P__HA
RD IZr -1 G.�t
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
!e_
y
OL -1, Q22z�_
(Signature of Notary Public- State of Florida
nature of Notary Public-
� P No Public State of Florid
Commission No. FF-976919 a° n(�1� N1iI�EAIi-Ararat
�Y PUB Notary Pubk State of Florida
C mi551on NO. FF976919 r° r�� c(Wl4)AIi-Ararat
v Rriy Commission FF 97691
Y s c i1�y Coifmissian FF 576319
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