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Date: 06/3012020 Permit Number:
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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: AC Changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 8aQ1 1 -ort Fierce Boulevard
Property Tax ID #: 1301-608-0125-000-5 Lot No. 20
Site Plan Name: LAKEWOOD PARK -UNIT 8- BLK 92 LOT20 (MAP 13102N) Block No. 92
Project Name:
DETAILED DESCRIPTION OF WORK:
AC CHANGEOUT
3.5 ton 15 SEER, York A/C system with 10 kw heat strip.
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
Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4522
_ Sprinklers _ Generator
Windows/Doors Pond
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name JOE BOLIVARD
Address: 9307 Fort Pierce Boulevard
Name: RAMON LALLOO
Company: FRIGID AIR LLC
City: FORT PIERCE State: _
Zip Code: 34951 Fax:
Phone No. (772) 979-1394
E -Mail: joblvd@att.net
Address: 1651 SE GOUCHO AVE
City: PORT SAINT LUCIE State: F
Zip Code: 34952 Fax:
Phone No 7722121123
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail RAY@FRIGIDAIR.COOL
State or County License CAC1819319
IT value OTconstruction is zsuu 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
vvvrvtK/ CON I HAL -FOR 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 borne 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 t 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 resutt in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Luci unty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
wifh nder ci.r4attorney before commencing work oT/fe—c6rding your Notice of Commencement.
as Agent for Owner
STATE OF FL
COUNTY OF
Swyrn to (or affirmed) and subscribed before me of
i� Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known _X_ OR Produced Identification
Type of Identification
Pr ced
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S natu
RACHAEL CLINTO
Commis ;Notary PublicState OfF� orida
q GG 3 r<892
My Commission Expires
REVIEWS I
COUNTER0I ROEVIEW I NINGS REVIEWOR
DATE
RECEIVED
DATE
COMPLETED
Holder
STATE OF FLORID
COUNTY OF
worn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of j\p 2020 by
Name of person making statement-
Personally
tatementPersonally Known OR Produced Identification
Type of Identification
" RACHAEL CLINTON
Commissio Notary Puhhc•State oi(6t b
ti ommrssion N GG 37842,
Commission Expiras
PLANS I VEGETATION
REVIEW REVIEW
-A I UKUL MANGROVE
f I REVIEW