HomeMy WebLinkAboutBuildingPermitApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/13/2020
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: AC changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 4004 Ave J. Fort Pierce, FL 34947
Property Tax ID #: 2405-703-0033-000-7
Site Plan Name:
Project Name: AC changeout -Young residence
Residential X
Replace existing AC system with new like for like system. 3.5 Ton / 14 SEER / 10 KW
New Electrical Meter
Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
x Mechanical
Electric
_Gas Tank
_Plumbing
Total Sq. Ft of Construction: 1,491
Cost of Construction: $ 6,422.51
_Gas Piping
Sprinklers
Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors
_Roof
Lot No. 17 & 18
Block No. 34
Utilities: _Sewer _Septic Building Height:
Pitch
: OWNER/LESSEE
CONTRACTOR: u�ti
Name Jacqueline L Young
Name: Paul Cloutier
Address: 4004 Ave J
Company: FPL Home Services
City: Fort Pierce State: _
Zip Code: 34947 Fax:
Phone No. 772-971-1435
Address: 582 N US HWY 1
City: Tequesta State: FL
Zip Code: 34947 Fax:
Phone No 561-575-5740
E-Mail: young1250@att.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail jordana.whitter@fpl.com
State or County License CAC1820030
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: x Not Applicable
MORTGAGE COMPANY: x— Not Applicable
Name:
Name:
Address:
Address.
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER, — 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 osted on the jobsite before the first inspection. If you intend to obtain financing, consult
with jppAeM 46 bJtqVneybefore commencing work or recordin1.yoSnotj0Commencement.
��7 -
ver� I O��
Veli /)ZZ
J, 4
Signat re of w r essee/ ctor as Agent for Owner
sign at e o Con If actor/ Icense 'HbiiTer
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Palm Beach
COUNTY OF Palm Beech
Swo to (or affirmed) and subscribed before me of
Swor to (or affirmed) and subscribed before me of
_ Physical Presence or 1 _ " Online Notarization
this 1`) day of ne � i4717IS 7m?n by
Physical Presences or Online Notarization
thlc 14a rlav of f"V4- JOJ A 7n,)n h.,
ate of Florid
dllinger
GG 914866
�23