HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: az Permit Number: add
RECEIVED
FEB 2 4 2020
__ -111110 0- 1111111w Building Permit Applica Jon
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE:Mechanical HVAC
;PROPOSED IMPROVEMENT LOCATION:
Address: 17 Castle Ct.
Property Tax ID#: 1414-701-0189-000-4 Lot No.F/3732-416
Site Plan Name: Block No. 19
Project Name: AC Change out
DETAILED DESCRIPTION OF WORK:
AC Change out of a 5 ton split system Goodman Air Handler ASPT35B14A, Condenser GSX140301 L 14 Seer
HVAC
FCONSTRUCTION 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:$ 2800.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name David&Rebecca Baselice Name:Stephan S Buckley
Address.320 Barclay Ave. Company:AC All Stars
City: Altamonte Springs, FL State:_ Address:21621 Magdalen Ter.
Zip Code: 32701 Fax: City: Boca Raton State:FL
Phone No.706-394-8871 Zip Code: 33433 Fax: 561-367-3444
E-Mail: Phone N0561-702-1943
Fill in fee simple Title Holder on next page(if different E-Mail sfaa4995@aol.com
from the Owner listed above) State or County License CAC1 817509
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: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 ATTORNEXREFORE RECO R NOTIC CEMENT."
Signature�FFLORIDA
0 r ntractor as Agent for Owner e o Contract /License r
STATE STATE OF FLORIDA
COUNTY OFPalm Beach COUNTY OFPalmBeach
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 17 day of February.2020 .20_ by this 17 day of February.2020 20_ by
David Baselice Stephan S BucMey
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification x Personally Known x OR Produced Identification
Type of Identification Type of Identification
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DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19