HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12-7-2020 Permit Number:
'COUNTY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
PERMIT TYPE: A/C CHANGE -OUT
PROPOSED IMPROVEMENT LOCATION:
Address: 3300 N HWY Al
Property Tax ID #., 1425-220-0001-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Commercial Residential X
Lot No.
Block No.
LIKE FOR LIKE REPLACEMENT OF (1) 12K BTU COOPER AND HUNTER MINI SPLIT, 21.5 SEER.
CONNECT TO EXISTING REFRIGERANT LINES, DRAIN, DUCTWORK, HIGH AND LOW VOLTAGE ELECTRIC.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical — Gas Tank —Gas Piping
_ Shutters _ Windows/Doors
_ Electric _ Plumbing Sprinklers
_ Generator Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ 4,250.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TR INT IMP TRUST FUND
Name: ,LAMES F. GRIMES
Address: 3300 N HWY Al
Company: GRIMES HEATING AND AIR CONDITIONING
City: FORTPIERCE State: FL
Address: 3054 N US HWY 1
Zip Code: 34949 Fax:
City: FORT PIERCE State: FL
Phone No. 772-595-5845
Zip Code. 34946 Fax: 772-461-8722
Phone No 772-461-8711
E-Mail: NA
Fill in fee simple Title Holder on next page ( if different
E-Mail ROBERTGRIMESAC@AOLCOM
from the Owner listed above)
State or County License 4426
If value of construction is $2500 or more, a RECORDED Notice of Commencement
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement
is required.
is required,
DES IGNER%ENGINEER: Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City:
State:
Zip: Phone
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 accessary uses to another non-residential use
"WARNING TO OWNER. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE TIME FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT'."
ature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA.
COUNTY OF :5cc eC
The fnrvning instrument wac acknowledged before me
this_Z�dayof C 2C120ry
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
ignature of Notary PuLate ofFlorida j
Commission No.
REVIEWS I FRONT N
COUNTER
DATE
COMPLETED
(S&gAN MONTENEGRO
MY COMMISSION # GG 089
EXPIRES: AAA# 2, 2021
REVIEW I REVIEW
7ature of ContractorAicense Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this —7 day of 2OZ l.by
Name of person making statement.
Personally Known !! „ _OR Produced identification
Type of Identification
Produced
nature of Notary Public- State of Florida }
mmission No. :' PS'''., Shc�iiErEGRe
PAY COMWISSfDN # CC 089099
a.
PnWoi Tft Nc ry Pu lit li ode rt tePS
NS VEG%TI
REVIEW REVIEW REVIEW REVIEW