HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/09/2020 Permit Number:
V
° 12 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: hvac change -Out
PROPOSED IMPROVEMENT LOCATION:
Address: 220 SE Calmino St, Port St Lucie, FI, 34952
Property Tax ID #: 341951502230005
Site Plan Name:
Project Name:
Residential x
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: I
Replace existing 5 ton system with Goodman 5 ton 16.0 seer w110kw heat
Models GSXC16060 & MBVC2000 & CAPF4860
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
ZMechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
Electric T Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5500.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Anthony Campbell
Name:Tracy Steele
Address: 220 SW Camino St
Company:Tracy D Steele Air Conditioning Inc
City: Fort St Lucie State:f'
Zip Code: 34952 Fax:
Phone No.912-358-6261
Address:2750 SW Edgarce St
City: Port St Lucie State:Fl
Zip Code: 34953 Fax:
Phone No72-336-2448
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail tdsac@aol.com
State or County License CAC035553
If value of construction is 2500 or more, a RECORDED Notice or Lommencemem is requireu.
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:
City: State:
Zip: Phone
Address:
City: State:
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 lanriar nr an attornev hpfnra rnmmPnrinLy work or recording your Notice of Commencement.
C
Signature of Owner/ esse ontractor as Agent for Owner
Signature ol Coclutracto License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUC[E
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 9 day of sFPT- 12020 by
this 9 day of SEPT 2020 by
TRACY D STEELE
TRACY D STEELE
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
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida J
Commission No.
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Stagy
' M commission GG 251653
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DATE
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