HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: f I -I [ zo Permit Number:
0
° 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 / Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 2110 N 45th St Fort Pierce, FI 34946
Property Tax ID#: 1 431- 8 0 2 - 0 0 0 3 - 0 0 0 - 0
Site Plan Name: 2110 N 45th St
Project Name: Joyce Crankfield
DETAILED DESCRIPTION OF WORK:
Exact AC change out, no duct work Z.cj j 0n 1 >kz' ( 16 �'V\f
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 T Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 6,000
Generator
Sq. Ft. of First Floor:
Lot No. 3
Block No. A
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Joyce M Crankfield
Name: Dennis Zacek
Address: PO Box 3821
Company: AIRS Rescue Rooter
City: Fort Pierce State: _
Address: 2800 US HWY 1
Zip Code: 34948 Fax:
City: Vero Beach State: FL
Phone No. 772-475-7083
Zip Code: 32960 Fax:
E-Mail:
Phone No 772-794-7205
Fill in fee simple Title Holder on next page ( if different
E-Mail mgillis@ars.com
from the Owner listed above)
State or County License CMC1249753
IT value or construction is ZSUU or more, a RECURRED 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
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 lender or an attorney before commencing work or recording our Notice of Commencement
5�>16M "v 3W_h1__
T:: ze� � �
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF StLvcie
COUNTY 0FstL-ie
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this 7 day of August 2020 by
this 7 day of . August 2020 b
--- y
Dennis Zacek
Dennis Zacek
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification x
Personally Known OR Produced Identification x
Type of Identification
Type of Identific1
Pro ced Drivers License
411,a,ur
11ation
Produc Driv License
Notary Public- a
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Commission No. cc sao,7s 3t�Iorida -Notary Pubi
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cCo mission No. GG 340,78 Statee{{iigi�ida - Notary Pub[
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My Commission expires May 30,
# (3(# 340178
MY Corainisa m Expkm May 30,
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