HomeMy WebLinkAboutmosely permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/06/2020 Permit Number:
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
PERMIT TYPE: HVAC Change out
PROPOSED IMPROVEMENT LOCATION.
Address: 7750 GULLOTTI PLACE. PORT ST LUCIE, FL 34952
Property Tax ID #: 341450111123006
Site Plan Name: _
Project Name: Mosley Change out
DETAILED DESCRIPTION OF WORK:
A/C change out. Same for same. i
One 3.5 ton 15 SEER Rheem remote air conditioning system complete with 10KW heat.
CONSTRUCTION INFORMATION: -_
Addi i nal work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ $4850.00
Sq. Ft. of First Floor: _
Utilities: _ Sewer _ Septic
Lot No.41080
Block No.
_ Windows/Doors
_ Roof Pitch
Building Height:
OW, NER/LESSEE:
CON-I-RACTOR
Name MATTHEW MOSLEY
Name: Juan Cruzado
Address: 7750 GULLOTTI PL
Company: Jensen Beach Air & Heat LLC
_
City: PORT ST LUCIE State:EL•
Zip Code: 34952 Fax:
Phone No. 7192136175
Address: 2092 SE Hanford Rd
City: Port St Lucie State: FL
Zip Code: 34952 Fax: n/a
Phone No 772-334-3200
E-Mail:
Fill in fee sirhple Title Holder on next page ( if different
from the Owner listed above)
E-Mail jensenbeachac@gmail.com
State or County License CAC1818779
.a�UC U wnxI vurvn a .?cavv yr mere, a KtLUKutu nimice oT commencement is required.
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City: Y
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
m i n T UUK LLNUM UK AN A 1 1 UKNtr I3tPURt RECORDING YOUR NOTICE OF COMMENCEMENT."
0
Sign of Owner/ Less /Contractor as Agent for Owner Sigtraawleof Contractor/Lic nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sT LUCIE COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6TH dad/ of JANUARY 20_ by this 6TH day of JANUARY 20by
JUAN CRUZADO JUAN CRUZADO
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 i Produced.
gnature o Not ry ubl'
a cn{�IE CRUZADO
(Signa e o otary Ic.G I� ofrFivrfL )
Commission No.
_ Ft-993217
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L5. 2020
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FF99321 rf QMMfS
Commission No. )dune 25, 2020
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Flondallowry Sarvir6'W"'
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REVIEWS
FRONT
ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER
REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED