HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/28/2020
i._
606
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
PERMITTYPE:A/C CHANGE -OUT
PROPOSED IMPROVEMENT LOCATION:
Address: 5104 MYRTLE DR.
Property Tax ID #: 3402-608-0305-000-7
Site Plan Name:
Project Name:
Commercial Residential X
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE REPLACEMENT OF (1) 3 TON TRANE A/C SYSTEM, 15 SEER WITH 10 KW ELECTRIC HEAT.
CONNECT TO EXISTING REFRIGERANT LINES, DRAIN, DUCTWORK, HIGH AND LOW VOLTAGE ELECTRIC.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
)(Mechanical _Gas Tank Gas Piping Shutters _ Windows/Doors
Electric
Total Sq. Ft of Construction:
Plumbing _ Sprinklers
Cost of Construction: $ 5,400.00
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name PARKER HAMBLETON
Name: JAMES F. GRIMES
Address: 5104 MYRTLE DR.
Company: GRIMES HEATING AND AIR CONDITIONING
City: FORT PIERCE State: ✓'—
Zip Code: 34982 Fax:
Phone No. 772-321-9552
Address: 3054 N US HWY 1
City: FORT PIERCE State: FL
Zip Code: 34946 Fax: 772-461-8722
Phone No772-461-8711
E-Mail: ROSERTGRIMESAC@AOL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail ROBERTGRIMESAC@AOL.COM
State or County License 4426
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.
i� RNfATEQ-N.
:DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Dame:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Andress:
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
strlucturin e. Plconflict nsult with your Home Owners Owners Association anrules,
review your deed or any restrictions which maor
apply Ebrt such
In consideration of the granting of this requested permit, 1 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 LAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SiITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
ww rw vA1 in'_FNnFR OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
5 `' ature of Owner) LeselCantractor as Agent far Owner
STATE OF FLORIDA
COUNTY OF
The fnraning instrampnr wnc acknowledged before me
this 15�day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
gnature of Notary Public- State of Florida
Sgh' AN MONTENEGRO
Commission No. 'P my COMMISSION mGG 08S
�. EXPIRES: ADIi 2, 2021
REVIEWS rRONT LUNINIa i -surcnvia
COUNTER REVIEW REVIEW
RECEIVED
DATE
COMPLETED
Si ature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Lu
The for Ding instrument was acknowledged before me
this Zr day of v1 2C Z D by
O''MQ.S IYL��S
Name of person making statement.
Personally Known OR Produced identification
Type of Identification
Produced
of [rotary Public- State of Florida)
No. SIJ(Sflai�'JTE NEGRO
MY COi M11I a10N 4 C-0 089099
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