HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/10/2020
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
PERMIT TYPE:Mechancial
PROPOSED IMPROVEMENT LOCATION:
Address: 5427 Place Lake Dr
Property Tax ID #: 1312-502-0098-000 5 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 3.5 ton 14 seer with 10kw
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. $ $3,600.00 Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Ray Brown Name: Shyan Wojtczak
Address: 5427 Place Lake Dr Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _ Address: 7901 Santana Ave
Zip Code: 34951 Fax: City: Fort Pierce State: FL
Phone No. 772-539-2634 Zip Code: 34951 Fax: 772-801-5398
E-Mail: Phone No 772-634-0491
Fill in fee simple Title Holder on next page ( if different E-Mail coolairsol@gmail.com
from the Owner listed above) State or County License CAC# 1819009
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:
Name:
Not Applicable
Address:
Address:
City: State;
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
w wv 1l -r%f _wiv i rimi_ i %in iirriervii E . Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no Mork 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_ Lune 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 OWNEIE YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROYEMENTS 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 COMMENCEMENT."
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Signature _00-tvner/ Lessee/Tghtra or as Agent for Owner Signature ofeontractor/Lice&,;,e Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF r ,-� i ti it COUNTY OF l C ✓e
The fargokng instrument was acknowledged before me The forgoing instrument was acknowledged before me
this _fcl Ny of EC b 20 X) by this % day of
Name of person making statement. Name of person making statement.
Personally Known "~~ OR Produced Identification Personally Known -� oR Produced Identification
Type of Identification Type of Identification
Produced Produced
:gnature c fiNo
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" ;rn EXPIRES April 43, 2C121 =•: MY COMMISSION # GGOSM7
Commission No. seal CommissionEXPIRES RpNO3(�Z"4
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED �
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