HomeMy WebLinkAboutApplication for Air Conditioning PermitJan-19-01 06:46P
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MASTER PERMIT:
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PERMIT NUMBER: 2-1 o 1 o3 Sa
ST. LUCIE COUNTY PUBLIC WORKS
BUILDING & ZONING DEPARTMENT
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34082.6652
661462-1553'
APPLICATION FOR
AIR CONDITIONING PERMIT
SEE REVERSE SIDE FOR INSTRUCTIONS
DATE: 1 / 18 / 01
1. LOCATION/SITE ADDRES�, 7169 SE Federal Highway Port St.. Lucie
2. PARCEL ID NUMBER: 3422-21 1 -001 0-0006
SECT %q TWP RNG L2LIMAP y ZNG CG,FLU INIT
3. DESCRIPTION OF PROJECT OR WORK ACTIVITY: Replace 3.0 tan Pkg Unit
LIST KW RATING FOR HEAT STRIPS: 8 kw
4. QWNERS INFOI�,f�AT)2N � L.Tt
Name: n o�i, r��..(1�JCAJ_�� a ...
Address: One Brightwood Lane
City: Bedmiu-c ter State: NJ
Phone: 908-234-9472 zip: 07921
5. CONTRACTORS INFORMATION
FL REG/CERT a:
COUNTY CERT 9. 18495
Busine66Name: MIranda Sales & Service
6. VALUE OF CONSTRUCTION: $ 2485.00 FEES DUE:
RECEIPT #: 01 3 3
OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will a ne in compliance with
all applicable laws regulating construction and zoning.
PRINT QUALIFIERSIOWNERS NAME SIGNAMURE OF QUALIFIERIOWNER
STATE OF FLORIDA, COUNTY OF S7-Z &,//
SWORN TO AND SUBSCRIBED BEFORE ME THIS JJCDAY OF3)Ih✓ 20- BY
WHO IS PERSONALLY KNOWN TOME OR WHO HAS PRODUCED[ ruv uu.ti AS IDENTIFICATION.
MARV ANN FUN(3ONE
ATURE OF NOTAR'f TYPE OR PRINT NAME OF NOTAi'�il % CommiKIJN 471574
N IMITU_BL_IC TITLE COMMISSION'!Y EIIPIKESAUUZ7,�2001
�i BONDED TNf1U
ti • 'IF ATLANTIC 30NDING CO., INC.
NOTICE TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH
CONTRACT UNDER $5,000. ?