HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: January 29, 2020 Permit Number:
COUNTY ".
F L O R 1 I7 R
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Fierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential
PERMITTYPE: Mechanical I
PROPOSED IMPROVEMENT LOCATION:
Address: 900 NW Winters Creek Road
Property Tax ID #t: 4422-805-0017-000-1
Lot No.
Site Plan Name: Block No.
Project Name: ,�� �il��,�• -
DETAILED DESCRIPTION OF WORK:
Exact A/C Change out; 5 ton 14 SEER 10kW heat strip
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:
Cost of Construction: $ 5800.00
OWNERAESSEE:
Name Christopher &Linda 5inkula
Address: 900 NW Winters Creek Road
City: Palm City
State:
Zip Code: 34990 Fax: NIA
Phone No.
E-Mail:
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Fill in tee simple Title Holder on next page ( if different
from the Owner lister! above)
CONTRACTOR:
Name: Jonathan Jones
Company: Jones A/C Services
Address: 4064 NW 2nd Court
City: Boca Raton State: FL
Zip Code: 33431 Fax: NIA
Phone No 561-755-0536
E-Mail into@jonesacservices.com
State or County License CAC1817489
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
MORTGAGE COMPANY: YG Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 1�6 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 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 NOTICE OF CO NCEMENT."
7M
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sig Lure of Contra or/Li nse Holder
STATE OF FLOR ' " "
COUNTY OF _ _ c� l�llci�`If.
STATE OF FLORID
COUNTY OF ���P/�n
The for oing instrument was acknowledged before me
this day of;)l�1n kD.Y �, 20'° by
The f r Ding instrument was acknowledged before me
this day of ZO_o by
LA. A'& c� V l
� 0 WA
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Type of ldentifcatian L'
Produced �n�t}' ll�E 7
Personally Known OR Produced Identification
Type of Identificatio
Produced
(Signature of Notary P bli
(Signature of Notary blic- S
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Commission No. ` N My Cq%I&ON #GG192976
W�� SPIRES: MAR 06, 2022
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4-V.r�B MARSHAJOKES
Commission No_ °� M1 06IIJSSION #GG192976
EXPIRES: MAR 06, 2022
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Rev. 7 1.