HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/04/2021 Permit Number:
IM LUC E \
0
V a 0 ° ° p Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 4880 N Kings Hwy, Fort Pierce, FL 34951
Property Tax ID #: Business Tax Account 2005003070
Site Plan Name:
Project Name: Loutina's Pizza
I DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 5 ton 14 seer no heat Goodman Package unit
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
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 4840.00
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Christina Silva / Lutina Enterprises, Inc
Name: Shyan Wojtczak
Address: 8243 S Indian River Drive
Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _
Zip Code: 34982 Fax:
Phone No. 772-595-9773
Address: 7901 Santana Ave
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No 772-634-0491
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail coolairsol@gmail.com
State or County License CAC# 1819009
IVd1UC V1 wIMIULLwn is cww or more, a KrLUKUtU Notice oT commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER: 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;
_J
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permitto 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 Horne Owners Association rules, bylaws or and covenants that may restrict or prohibit such
1 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,
1 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature szf)Owner/ Lessee/(Zgkza�ctor as Agent or -Owner
Signature of Eo'ntractor/Licer6e Holder
STATE OF FLORIDA f
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COUNTY OF,- r -i Vey
STATE OF FLORIDA
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COUNTY OFr/ -) i v
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this ZILJ-day of., fl�(dddl .20_,91 by
this L�clay of -c-: 1-1 .20-c-9 by
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Name of person making statement.
Name of person making statement.
Personally Known , ' OR Produced Identification
Personally Known --- OR Produced identification
Type of Identification
Type of Identification
Produced
Produced
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{Signature
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EXPIRES ' April 03,2021
Commission No,"' Seal
Commission
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EXPIRES
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REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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