HomeMy WebLinkAboutPermit app for Anne Nelson 5105 Paleo Pines CircleAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/5/2020 Permit Number:
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 APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 5105 Paleo Pines Circle
Property Tax ID #: 1312-801-0145-000-8 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 heat
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION: J
Additional work to be performed under this permit— check all that apply:
Mechanical __._ Gas Tank . Gas Piping _ Shutters _ Windows/Doors Pond
_ Electric _ Plumbing _ Sprinklers — Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ $3,600 Utilities: —Sewer —Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Anne Nelson
Name: Shyan Wojtczak
Address: 5105 Paleo Pines Circle
Company: Cool Alr Solutions of Florida, Inc.
City: Fort Pierce, FL State:
Zip Code: 34951 Fax:
Phone No. 772-971-6149
Address: 7901 Santana Ave
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No 772-634-0491
E-Mail-
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail coolairsol@gmail.com
State or County License CAC# 189009
1i va!uc u1 LUn:biru"Jun is zDuu or more, a KtwKutu Notice of Lommencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLE MENTAL:CONSTRUCTION LIEN t:AW. iNFOWATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY- , Not Applicable
Name: Name:
Address: Address:
City, State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE BOLDER: _ 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 dome Owners Association rules, bylaws or anr3 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 MIDST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
w mm Ynt iQ i F"unFR nR Am & f'nRNFY RFFnRF RFCnRniNG YOUR NOTICE OF C_GM YIFNCI:'1MENT"
Signature zoOwner/ Lessee( o' tra`ctor as Agent for Owner
Signature of �-bntractor/License Holder
STATE OF IFLORIDA r—r-�
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STATE OF FLORIDA
COUNTY OF
COUNTY OF —fY ICI �� i
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The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
.;
this day of ,1 u,-C--'- 20.ae- by
this_�ay of ___ _ , 20 by
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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
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(Signature aV_W%RubWAWW
,,,, EXPiRirS April 03, 2021
;' MY COMMISSION #I GGOSM?
Commission iVo. seal
CommissionEXPIRES April 49wo
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