HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/8/2020 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:MECHANICAL
PROPOSED IMPROVEMENT LOCATION:
Address: 8824 Bally Bunion Road
Property Tax I D #.. 3334-600-0010-000-0
Site Plan Name:
Project Name: Hellstrom-Residence
DETAILED DESCRIPTION OF WORK:
Like for like HVAC System Replacement
5 Ton, 16 seer, 5kw, Vertical -Ground
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Residential xxxx
Lot No._
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers A Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 7432.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameAlexandra Hellstrom
Name: Don Miranda
Address:8824 Bally Bunion Road
Company: Miranda Plumbing & Air Conditioning
City: Port St Lucie State: _
Zip Code: 34986 Fax:
Phone No.772-878-5123
Address:750 NW Enterprise Drive
City: Port St Lucie State: FL
Zip Code: 34986 Fax:
Phone No
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Ldiodato@mirandacompanies.com
State or County License CAC1815486
11 vdiue or construction is c5uu or more, a Kt:LUKUt:U 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:
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 rded in the public records of St.
Lucie Cou r"i —ppsted on the jobsite before the first inspe If you inten p obtain financing, consult
with I der or an aptorney before commencing work or reArding your Notice of Commencement.
r
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie
COUNTY OF St Lucie
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this 3, a day of 2020 by
Physical Presence or Online Notarization
this _3LLL day of P) t yti 2020 by
Don J Miranda
Don J Miranda
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
TypeP€;Identification ��� !)'�� sari Diodato
Pr 6e � �� .� 4 Commission # GG069258
Personally Known x OR Produced Identification
Type of Identification ��"�i'��d",., Lori 10 0
Produce a * .:Fit Commission # GG06
_ Expires: Feb. 9, 2021
�,.. -�" Bond P.tl thru Aaron Notary
*' " Expires: Feb 9,
U,. y,�',�_. '.J !'-` off •'',,��' Bonded thru Aaron Nota
0
(Signature of Not
(Signature of Notary Public- State of Florida )
Commission NO. FF945187 (Seal)
Commission No. FF945187 (Seal)
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