HomeMy WebLinkAbout6630 S US Highway 1_St. Lucie Draft HousePLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
COUNTY
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
X CHANGE OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2,500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing any work. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
_ CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the permit.
Date: 08/20/2020
Site Address: 6630 S US HIGHWAY 1
Permit Number: 1706-0449
A/C ADVANTAGE INC. State License CMC1249807 SLC License
Original GC, subcontractor or owner/builder
A/C CARE LLC
New GC, subcontractor
Reason for Cancellation
State License CAC1818622 SLC License
The undersigned does hereby agree to indemnify and hold harmless St Lucie County, its officers, agents and employees from all
costs, fees or damages arising from any and all claims of action for any reason, which may arise as a result of this change of
contractor/subcontractor or cancellation of permit. A permit cannot be canrelle[ ` o has been performed.
SIGNATURE OF OWNER (or owner/builder) SIGNATCIR' G . CONTRACTOR (or new GC, as applicable)
PRINT NAME PRINT NAME_
State of Florida, County of St, Lucie County State of Florida, County of St Lucie County
The following instrument was acknowledged before me this
day of , 20_, by
who is personally known to me
or who has produced as 1D.
Signature of Notary Date
Revised 04/15/16
The following instrudnent was rknowledged before me this
2aduy of 20why
who is personally known to
me or who need as 1D.
Signature of Nn , '�' tc Y�PINZON
MY COMMISSION # GG086200
*?oro EXPIRES March 22, 2021
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/20/2020 Permit Number: 1706-0449
S57o [LUCE �-
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: MECHANICAL
PROPOSED IMPROVEMENT LOCATION:
Address: 6630 S US HIGHWAY 1
Property Tax ID #. 3415-501-0065-030-3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
CORRECTIONS TO ROOFTOP UNIT AND REPAIRING DAMAGED DUCTWORK
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
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
Total Sq. Ft of Construction:
Cost of Construction: $ 4.825
OWNER/LESSEE:
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Name Rest LLC
Address: 5339 NW Milner Dr
City: PORT SAINT LUCIE State: FL
Zip Code: 34983 Fax:
Phone No. 772-359-8056
E -Mail: sportsnut2910@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: DONALD MYERS
Company: A/C CARE LLC
Address: 3324 SE GRAN PARK WAY
City: STUART State: FL
Zip Code: 34997 Fax: 772-252-3231
Phone No 772-266-2665
E -Mail OFFICE ACCARE.BIZ
State or County License CAC1818622
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:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
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 on the jobsite before the first inspection. If you inter tarn financing, consult
with lender or attorn_ y before commencing work or recording your Nol4iffieof Com encement.
Signature of k1wfier
ntractor as Agent for Owner
STATE OF FPORIDA `
COUNTY OF I..ta +,V1
5wgrfi to (or affirmed) and subscribed before me of
,7// to
Presance or [inline Notarization
this 24D day of 2020 by
Name of person
Personally Known
Type of Identificati
re of Notary Public -
Commission No.
ARI_Y PINZON
'�e@l� 4t8d�Sdtli� coati c3�fi�;
EXPIRES March 22. 2021
op
ffiarida )
(Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Signature of
STATE OF FLGAIDA
COUNTY OF H 4 -h
l,'C
Sworn to (or affirmed) and subscribed before me of
,V Physical Presence or Online Notarization
this day
day of��, 2020 by
�__
__ t
Name of person making Mate ent.
Personally Known ,T,! OR Produced Identification
Type of Identification
Produced
PINZON
__7
(Signaty EX IIR aM1 aroch 2�r
Commis '
SUPERVISOR I PLANS I VEGETATION SEA TURTLE MANGROVE
REVIEW I REVIEW REVIEW REVIEW REVIEW