HomeMy WebLinkAboutPelican Plaza PermittAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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
PERMIT TYPE: A/C Change Out
PROPOSED IMPROVEMENT LOCATION:
Commercial X Residential
Address: 10554 US Highway 1
Property Tax ID #: 3414-501-4712-250-7 Lot No.
Site Plan Name: Block No.
Project Name:
i
DETAILED DESCRIPTION OF WORK:
A/C Change Out Like for Like
2.5 Tans, 14 Seer, & 8KW
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. $ 4786.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Daniel Shawver/DS Air Conditioning, Inc
Name: Daniel Shawver
Company: DS Air Conditioning, Inc.
Address: P.O. Box 197
City: Jensen Beach :- _ . State: _
Address: P. O. Box 197
Zip Code: 34958 - Fax: 772-679-0130. •
City: Jensen Beach State: FL
Phone No.772-335-4531
Zip Code: 34958 Fax: 772-679-0130
E-Mail: info@dsairconditioning.com
Phone No772-335-4531
Fill In fee simple Title Holder on next page ( if different
E-Mail info@dsairconditioning.com
from the Owner listed above)
State or County LicenseCAC058715
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:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State: _
City:
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 INTENO TO OBTAIN FINANCING, CONSULT
as Agent for Owner
The forgoing instrument was acknowledged before me
this Il day of Ma 20 a0 by
Aaniel SN�uoy6'
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
STATE OF
The forgoing Instrument was acknowledged before me
this _IL_day off 20.0 by
Danlel nhaoVeK
Name of person making statement.
Personally Known 1/ OR Produced Identification
Type of Identification
REVIEWS COUNTER I REVIEW SREVIEW R I REVIEW REVIEW REVIEW LE MEV� WVE