HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/23/2020 Permit Number:
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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 Changeout
PROPOSED IMPROVEMENT LOCATION:
Address: 2404 Blossom Ct, Fort Pierce, FL 34982
Property Tax ID #: 2421-609-0008-000-4 Lot No. 7
Site Plan Name: ORANGE BLOSSOM ESTATES-2ND ADDN-2ND PLAT BLK 5 LOT 7 Block No. 5
Project Name: A/C Changeout
DETAILED DESCRIPTION OF WORK:
Like for like packed ac change out. Same location same size.
'7
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 Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David Fredy
Name: Anthony Fenn
Address: 2404 Blossom Ct
Company: A. S. Fenn LLC dba Assured Air Conditioning
City: Fort Pierce State:
Zip Code: 34982 Fax:
Phone No. (609)892-5393
Address: 278 NE Surfside Ave
City: Port St Lucie State: FI
Zip Code: 34983 Fax:
Phone No (772)202-2005
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail anthony.fenn@assuredairconditioning.com
State or County License CAC1820274
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
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: X 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 recording your Notice of Commencement.
`Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature bf Contractor/License Holder
STATE OF FLORIDA,. /
STATE OF FLORIDA '
COUNTY OF ri'Gr;GC
COUNTY OF U ANl
Sworn to (or affirmed) and subscribed before me of
Swn to (or affirmed) and subscribed before me of
V h sical Pres n e ppr Online Notarization
�C��(j
Ph sical Pres n r Online Notarization
this day of 2020 by
this day of 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifldon
Produced L `��0 1 �� �jo P `�
Type of Identif tion /
Prod,
., BELINDA DARDEN
. %;,;; •., BELINDA DARDEN
" Notary Public - State of Florida
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