HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMP
Date: 2/5/2021
Sa o U11CCU 1E,
FOR APPLICATION TO BE ACCEPTED
Permit Number:
uilding 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)462-1 78
Residential X
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOC TION:
Address: 3800 SHADBERRY CT
Property Tax ID #: 3425-703-0204-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF Wo l<:
LIKE FOR LIKE 3 TON 14 SEER PACKAGE UNIT WITH 10 KW HEAT
New Electrical Meter Second lectrical Meter
CONSTRUCTION INFORIMATION:
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
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4350 Utilities: —Sewer _ Septic
Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name PEGGY GERMANO
Name: CURTIS SAMMONS
Address: 1124 7TH AVE
City: WATERVLIET
Company: CUSTOM AIR SYSTEMS INC
State: _
Address: 1615 SE VILLAGE GREEN DR
Zip Code: 12189 Fax:
Phone No. 518-466-0089
E-Mail:
City: PORT SAINT LUCIE State: FL
Zip Code: 34952 Fax: 772-335-1968
Phone No 772-335-3232
Fill in fee simple Title Holder on next page
from the Owner listed above)
( if different
E-Mail CUSTAIRSYS@AOL.COM
State or County License CAC051810
it value or construction is zbuu or more, a REC RDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORD D Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
LIEN LAW INFORMATION:
ENGI
DESIGNER NEER: N
� --
Name:
Address:
City:
Zip: Phone
Applicable
pp
MORTGAGE COMPANY: Not Applicable
Name:
Address:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not
Name:
Address:
City:
Zip: Phone:
Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: App
I certify that no work or installation has Comm
on is hereby made to obtain a permit to do the work and installation as indicated.
d 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 Ow rs Association and review your deed for any restrictions which may apply.
In consideration of the granting of this reques
in accordance with the approved plans, the Fli
The following building permit applications are
accessory structures, swimming pools, fences,
WARNING TO OWNER: Your failure to I
improvements to your property. A
Lucie County and posted on the jot
with lender or an attorne before c
d permit, I do hereby agree that I will, in all respects, perform the work
da Building Codes and St. Lucie County Amendments.
tempt from undergoing a full concurrency review: room additions,
,alls, signs, screen rooms and accessory uses to another non-residential use
!cord a Notice of Commencement may result in paying twice for
lotice of Commencement must be recorded in the public records of St.
ite before the first inspection. If you intend to obtain financing, consult
m encing work or recording our Notice of Commencement
Signature of Owner/ Lessee/Contractor as A
ent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF C
Sworn to (or affirmed) and subscribed before
me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Not
rization
v Physical Presence or Online Notarization
this _ _ day of �- Q,`p�C,.C`c_, 2020
by
this -e,_ day of i - Q-b2 3-± 2020 by
cp c, rrnmd
`J
_ �7 r'�'��:J SO, Yr ma n5
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Ide
tification
Personally Known IOR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary blic- St of Florida)
(Signature of Notary Public- Stat f Florida }
D ra S ?�, �
CommissionNo. inVl d
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April4,2021
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DATE
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