HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 061/7 ZUZU Permit Number:
g`z i � r COOL
P L c L L11 & 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:A/C 3.5 TONS Package Unit Change Out
PROPOSED IMPROVEMENT LOCATION:420 Natalie DR, Port Saint Lucie FL 34952
Address: 420 Natalie DR, Port Saint Lucie FL 34952
Property Tax I D #: 3426-664-0005-000-2
Site Plan Name:
Project Name: A/C Change Out
DETAILED DESCRIPTION OF WORK:
A/C 3.5 TONS Package Unit Change Out- SEER 14/ 10KW Heater - No Duct Work
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: $ 3700
Generator
Sq. Ft. of First Floor:
Lot No. 5
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Norene E Michalik
Name: Karen Oliver
Address: 420 Natalie DR
Company: AAA A/C QUALITY SERVICES
City: Port Saint Lucie State: _
Zip Code: 34952 Fax:
Phone No. 772-342-0315
Address: 126 Valencia ST
City: Royal Palm Beach State: FL
Zip Code: 33411 Fax:
Phone No 8005069429
E -Mail: nmichalik@comcast.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail aaaacqualityservices@gmail.com
State or County License CAC 1818921
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.
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:_
BONDING COMPANY: Not Applicable
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 atto_wey before commencing work or recording your Notice of Commencement.
ign t e of ner/ Lessee/Contractor as Agent for Owner
�'__J
IAJ
Signaltre of Con actor/License Holder
STATE OF FLORIDA
STAT OF FLORIDA
COUNTY OF SAINT LUCIE
COUNTY OF SAINT LUCIE
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 » day of AUGUST 2020 by
this 17 day of AUGUST 2020 by
Norene E Michalik
Karen Oliver
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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SEA TURTLE
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REVIEW
REVIEW
DATE
RECEIVED
DATE
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Rev. 5/b/ZU