HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/17/20 Permit Number:
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:EMERGENCY HVAC Mechanical A/C Change Out LIKE FOR LIKE
PROPOSED IMPROVEMENT LOCATION:
Address: 6713 Gaviota Fort Pierce, FL 34951
Property Tax ID #: 1306-500-0035-000-1
Site Plan Name: SPANISH LAKES FAIRWAYS BLK 38 LOT 20 (OR 3598-1210)
Project Name: EMERGENCY HVAC Mechanical A/C Change Out LIKE FOR LIKE
Lot No.20
Block No. 38
DETAILED DESCRIPTION OF WORK:
Emergency HVAC Mechanical A/C Change Out Install RHEEM 2.5 TON 15.5 SEER 5KW HEATER LIKE FOR LIKE
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION: i
Additional work to be performed under this permit— check all that apply:
X Mechanical _.._ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors - — Pond
Electric — Plumbing _ Sprinklers — Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5,000.00
Sq. Ft. of First Floor:
Utilities: _ Sewer — Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Sharon Gibson
Name: Kelly Certosimo
Address:6713 Gaviota
Company:Air Temp Air Conditioning
City: Fort Pierce State:
Zip Code: 34951 Fax:
Phone No. (518) 482-7428
Address:1384 NW Commerce Centre Drive
City: Port Saint Lucie _ State: FL
Zip Code: 34986 Fax: _
Phone No(772) 340-0740
E-Mail: ericsplace@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail airtempac@yahoo.com
State or County License CAC1814837
it value of construction is Z500 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: Phase
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 attorney before commencing work or recordin& your Notice of Commencement.
Signature of Owner/ Le see/Contractor as Agent for Owner
Signature of Contra r/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
yrnto(or affirmed) and su before me of
Physical Pre nceor . Online Notarization
2020 by r
Sw rn to (or affirmed) and subscribed before me of
Physical Pre ce r Online Notarization
this day of 2020 by
To
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Name of p rson k' statement.
Na a bftierson aki statemen .
Personally Known ucd��t Florida
Type of Identificab n �- atherine Drina M ,
Y My COmmi55fon GG 176881
Prod C d 'E o� Ex Fes 0111812022
Personally Known OR Produced Identification
Typ Identificati n'
Pr uc . ou Notary Public State of Florida
4 Catherm Donna Mahan
r o y Com ss"on GG 176681
�Y x rat 11812022
(Sig o o ary Public- a �di-)
Commission No. E(Seal)
(Si 'ture of Notary P
Commission No. Seal)
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20
IN W ITNJCSS WHEREOF, Grantor has hereunto set grantor's hand and seal the day and year first above
written.
Signed, s d and delivered in our presence: Assignor(s)
tltess .. Gary L. Its
Me se print Warne below signature)
witne s: Debor h L. Evans
(Please print name below signature)
STATE OF FLORIDA,
COUNTY OF St LjCI
The foregoing instruinent was ackwwledged before me by means of +.�" pJ�ysical presence or _online
notarization this day of August, 2020 by C L. Evans and Deborah L. Evans, who are personally
mown to me or have produced �� as id atti to aion.
[Seal] Notary Public
Printed Name: ,
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My Commission Expires:
�i�sr Loren M. Maccarone
a� Notary Public
q State of Florida
w Cornm# GG987880
�kc l Exoires 5/2912024