HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01-30-2020 Permit Number:
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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
PERMITTYPE:hVaC Change -out
PROPOSED IMPROVEMENT LOCATION:
Address: 8160 Mulligan Cir, Port St Lucie, FI 34986
Property Tax ID #:
Site Plan Name:
Project Name:
Lot No.
Block No.
6 DETAILED DESCRIPTION OF WORK: I
Replace existing 3 ton system with Goodman 3 ton 16.0 seer w/10kw heater
Models GSX16036 & ASPT47D
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: $ 4000.00 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Domingo Sanchez
Name:Tracy Steele
Address: 8160 Mulligan Cir
Cornpany:Tracy D Steele Air Conditioning Inc
City: Port St Lucie State: Fi-
Zip Code: 34986 Fax:
Phone No.772-342-1468
Address:2750 SW Edgarce St
City: Port St Lucie State: FI
Zip Code: 34953 Fax:
Phone No772-215-1974
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailtdsac@aol.com
State or County License CAC035553
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
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:
OWNED/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 114OTICE OF COMMENCEMENT."
Signature of Owner/ Les e/C actor as Agent for Owner
Signature of Co actor/L' ense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF st t.ucie
COUNTY OF st Lucie
The forgoing instrument was acknowledged before me
this 30 day of January 20 20 by
The forgoing instrument was acknowledged before me
this 30 day of January 20 � by
Tracy D Steele
Tracy D Steele
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
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(Signature of Notary Public- State orida)
(Signature of Notary Public- State o Florida )
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