HomeMy WebLinkAboutBuilding PermitAIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
oate: ;l - \- i)7.)Permit Number:
Building Permit Application
Planning and Develapment Services
Building and Code Regulation Divisian
23A0 Virginia Avenue, Fort Pierce FL 34982
Phoner (7V2) 462-1553 Fax: (7721 462-1578 Commercial Residential x
PERMIT TYPE:
PROPOSED IMPROVEM ENT LOCATION:
Address: 3168 Columbrina Cir Port St. Lucie, FL 34952
Property Tax lD #;3425-742-0044-000-9 Lot No
Site Plan Name:Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Replacement of a 2.5 ton packaged unit with 10 kW electric heat; like for like; 14 SEER
CONSTRUCTION IN FORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
_ WindowsfDoors
_ Roof _ Pitch
Total Sq. Ft of Construction:Sq. Ft. of First Floor:
Cost of Construction: $ 3956 Utilities: _Sewer _Septic Building Height:
lf value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is 57,500 or more, a RECORDED Notice of Commencement is required.
OWNER/LESSEE:CONTRACTOR:
53mg David and Patricia Dalton
Address: 3168 Columbrina Cir
City' Port St. Lucie, FL t,r,",
ZiP Code: 34952 Fax:
phone 11s. 772-323-0661
E-Mail:
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
Name: James J Wauters
Company:Just Chillin'HVAC LLC
Address:5422 NW Cromey St
City:Port St. Lucie State: FL
ZiP Code: 34986 Fax:
phone p6 772-940-4373
p- 1y 3 ; I j ustch i lli nai r@hotmail.com
State or County 1;5g65s CAC1819351
,:i
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City:State:
zip:Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:State:
Zip:Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
zip:Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Phone:
owNERl 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 Countv makes no reoresentation that is erantins a permit will authorizethe permit holderto build the subiect structure
which is in conflict with anv a'pplicable Home Owhers AsSociation rules, bvlaws or and covenants that mav restrict cir prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
ln 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
..WARNIIIIG TO OWIUER: YOUR FAILURE TO RECORD A NOTICE OF COMilEiICEMEI{T MAY RESULT IIU YOUR PAYING
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A I{OTICE OF I}IUsT BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU IITTEND TO OBTAIN FIiIANCING, CONSULT
WITH YOUR LENDER OR ATT ATTORNEY BEFORE RECORDITTG YOUR NOTICE OF COMMENCETIIENT."
STATE OF FLORI
COUNTY OF
The forgoing instrument was acknowledged before me
this_l l-dayof i. : ,20 ,'by
Name of person making
OR Produced ldentification \
actor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The fqrgeing ins
this day of
Name of person making statement.
Personally Known _ OR Produced ldentification \..
State of Florida )
(#ttt.-{o4
SUPERVISOR
REVIEW
DATE
COMPLETED
SUPPLEMENTAL CONSTRUCION LIEN LAW INFORMATION:
Zip: _
Commission No.