HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/6/20 Permit Number:
0..
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: AC CHANGEOUT
PROPOSED IMPROVEMENT LOCATION:
Address: 13521 S INDIAN RIVER DR #1003
Property Tax ID #: 4509-804-0064-000-8
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
LIKE FOR LIKE AC CHANGEOUT, 2.5 TON 14 SEER GOODMAN WITH 8 KW HEATER
CONDENSER MODEL* GSX140301
AIR HANDLER MODEL #: ARUF31 B14
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 _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 3,987
Generator
Sq. Ft. of First Floor:
X
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name KERI SALERNO
Name: DAVID WAYNE MACGEORGE JR
Address: 13521 S INDIAN RIVER DR #1003
Company: ALWAYS COOL, INC.
City: JENSEN BEACH State: _
Zip Code: 34957 Fax:
Phone No. 772-404-9809
Address: 1952 SE FALLON DR
City: PORT ST LUCIE State: FL
Zip Code: 34983 Fax: 772-828-1771
Phone No 772-801-8922
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail INFO@ALWAYSCOOL.COM
State or County License CAC1820160
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.
SUMEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE
Name:_
Address:
City:
Zip:
INEER:
Phone
_ Not Applicable
MORTGAGE COMPANY:
Name: /
Address: _
City: _
Zia• Phone:
_ Not Applicable
e:
FEE SIMPLE TITLE HOLDER: — Not Applica e' BOND MPANY: _Not Applicable
Name: Name:
Address: Address:
City: / City:
Zip: Phor>e: Zip: Phone:
OWNER/,C@NTRACTOR 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 inspewpn. If you intend to obtain financing, consult
with leer or an attornev before commencing work or rer,6rclyng your Notice of mmencement.
G
Signl,Y&re of Owner/ Lessee ntrac or as Agent for Owner
Signature of Contra ctor/L ens,J Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S7".� «ice
COUNTY OF S 77
Sworn to (or affirmed) and subscribed before me of
SworqAo or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Ph sical Presence r Online Notarization
this day of %u, 2020 by
this��day of 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification ✓
Personally Known OR Produced Identification
Type of Identification /
Producecyz-19 � �1rld,� s �4 ° e1 A Tait
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Type of Identification
Produced _ c ��z�g �2�dE�2 f eE 1soB
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(Signature of Notary Public- State of Florictlt ;gnature
of Notary Public- State of Florida$ Z r '
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`tg'mmission No. / (S� No. GG 124151 .
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