HomeMy WebLinkAboutPermit App for 6622 Fort Pierce Blvd Petra Paul LeitkowskiAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/8/2020 Permit Number:
O
3 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:MechanClal
PROPOSED IMPROVEMENT LOCATION:
Address: 6622 Fort Pierce Blvd
Property Tax ID #: 1301-607-0348-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 3.5 ton 14 seer package unit with 10kw heat
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical — Gas Tank —Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 3400 utilities: —Sewer —Septic
X
Lot No.
Block No.
Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Paul & Petra (Carrie) Leitkowski
Name: Shyan Wojtczak
Address:6622 Fort Pierce Blvd
Company: Cool Air Solutions of Florida, Inc.
City Fort Pierce, FL State: _
Zip Code: 34951 Fax:
Phone No. 561-236-9810
Address: 7901 Santana Ave
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No 772-634-0491
E-Mail: askpetranow@gmail.com
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 # 1819009
If value of construction is 2500 or more, a RECORDED Notice of commencement is requireo.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLE MENTALCONSTRUCTI[ON 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: _ w 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature aaVOwner/ Lessee/�-Owner .as Agent for Owner
Signature of C-ontractorce Linse Helder
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STATE OF FLORIQA
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STATE OF FLORIDA
COUNTY OF :�lGyE G
The forgoing instrumen was acknowledged before me
The forgoing instrument was acknowledged before me
this day of J U tSj 20 dc-1by
this _r'day of J U I L4 20 C1by
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Name of person making statement.
Name of person making statement.
Personally Known e OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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ignature :No fa�B81QD�iE10B99 7
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' EXPIRES April 03, 2021
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Commission No. Seal
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EXPIRES April 0X-9MR4
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