HomeMy WebLinkAboutPermit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )) //�
Date: 06/20/2020 Permit Number: 7`�!L)(i — y 17
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c ` 0 F ` `' L1 _ " Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: HVAC installation
PROPOSED IMPROVEMENT LOCATION:
Address: 5501 Hickory `Drive, Ft Pierce, FL 34982
Property Tax ID#: �t�� 11;L�'I U AGO Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Installation of 3.5 ton 14 SEER 240 KW Goodman air conditioning unit
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: $ } 00. Ulu Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jose Goycochea Name:
Address: 5501 Hickory Drive Company:
City: Ft Pierce State:_ Address:
Zip Code: 34982 Fax: City: State:
Phone No. 772-672-1113 Zip Code: Fax:
E-Mail: Jgoycochea47@gmail.com Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
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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 TITLE HOLDER: _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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lepAff:��12rney before commencing work or recording our Notice of Commencement.
Si ture 0 essee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOR A STATE OF FLORIDA
COUNTY OF 24/2 COUNTY OF
S n to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
P sical Presence or Online Notarization
Y o Physical Presence or Online Notarization
Y
this 9- dayof 2020 b this
c�U to e y t s day of , 2020 by
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Name of person makink statement. Name of person making statement
Personally Known OR Produced Identification /�}� Personally Known OR Produced Identification
Type of Iden ' icati n Type of Identification
Produced Produced
e of Not u to of Florida } (Signature of Notary Public-State of Florida )
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Commission No. o ip (Se Commission No. (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED f
DATE
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