HomeMy WebLinkAboutSLC CulkinAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/23/2021 Permit Number:
w ■
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: HVAC Change -out
PROPOSED IMPROVEMENT LOCATION:
Address: 7312 Mystic Way
Property Tax ID #:
Site Plan Name:
Project Name:
332262000260000
I DETAILED DESCRIPTION OF WORK:
Commercial Residential X
Replace existing 5 ton system with Goodman 5 ton 16.0 seer w/10kw heat
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
ZMechanical — Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 5500.00
Sprinklers — Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE.
CONTRACTOR:
Name Gerald (j�(ulkin
Name:Tracy D Steele
Address: 7312 Mystic Way
Company:Tracy D Steele Air Conditioning Inc
City: Port St Lucie State: FZ-
Zip Code: 34986 Fax:
Phone No. 772-489-0542
Address:2750 SW E=dgarce St
City: Port St Lucie State: FI
Zip Code: 34953 Fax:
Phone No 772-336-2448
E-Mail:
Fill in flee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail tdsac@aol.com
State or County License CAC035553
it vawe or consiruction is �>zsuu or more, a KtC(JKVtU Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL, CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/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 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
Ne of Commencement.
with lender or an attorney before commencing work or r=ofContrackor/;Lice
Signature of Owner/ ssee/C tractor as Agent for Owner
Signature t#lder
STATE OF FLORIDA
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 1Q, day of M 2Q�Wby
this ��day of +�'1r4s r� 2Q by
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
Produced
(Signature of Notary Public- State of Florida)
{Signature of Notary Public- State ofE6rida )
Commissio a
Commis
a ery . 5teM ofiorid
Daniel IF Stacey
Nomry AutaNc 8te1. of Fiprida
Daniel F Stacey
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