HomeMy WebLinkAboutSLC MILLER 27thAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/20/2020 Permit Number:
S57o LUC
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 31982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: hcac change -out
PROPOSED IMPROVEMENT LOCATION:
Address: 2703 S 27th St, Ft Pierce, Fl
Property Tax ID #: 242080200340005
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace existing 2.5 ton system with Goodman 2.5 ton 16.0 seer w/5kw heat
Models GSX16031 & ASPT37B
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
Lot No._
Block No.
Additional work to be performed under this permit– check all that apply:
,Mechanical _ Gas Tanis _ Gas Piping _ Shutters _ Windows/Doors _ Pond
— Electric —Plumbing —Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 4500.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building, Height:
OWNERAESSEE:
CONTRACTOR:
Name Michael Miller
Name: Tracy D Steele
Address: PO Box 13208
Company: Tracy D Steele Air Conditioning Inc
City: Ft Pierce State:
Zip Code: 34979 Fax:
Phone No. 772-216-1872
Address: 2750 SW Edgarce St
City: Port St Lucie State: Fl
Zip Code: 34953 Fax:
Phone No772-215-1974
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 2504 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:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone
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 IPnrl,?r or an attornev before commencine work or recordiniz vour Notice of Commencement.
Rev. 5/6/20
Signature of Owner/ Le see/Con actor as Agent for Owner
Signature of Contra for/L ease Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
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 20 day of NOVEMBER 2020 by
this 20 day of NOVEMBER 2020 by
I
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 I
Produced
f
..f 'ZI—
(Signature of NotaryPublic- State of Florida }
(Signature of NotaryPublic- State orFlorida
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E OsO$122/2022
Expires 051 2/2022
REVIEW
UPERVISOR
PLANS VEGETATION
SEA TURTLE
MANGROVE
COUNTER REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20