HomeMy WebLinkAboutSLC BUNTINGAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/19/2021 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: HVAC Change -Out
PROPOSED IMPROVEMENT LOCATION:
❑rlrlracc. 5809 Hickory Dr, Ft Pierce, FI 34982
Property Tax ID #: 340260904340003
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace existing 3 ton system with Goodman 3 ton 14.0 seer w18kw heat
Models GSX14036 & ASPT35B
CONSTRUCTION. INFORMATION.
Addal work to be performed under this permit —check all that apply:
itiMechanical Gas Tank Gas Piping Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction. $ 4500.00
Sq. Ft. of First Floor: _
Utilities: —Sewer _Septic
Lot No._
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Ralph Bunting
Name:Tracy D Steele
Address: 5809 Hickory Dr
Company.Tracy D Steele Air Conditioning Inc
City: Ft Pierce State:
Zip Code: 34982 Fax:
Phone No. 7-22 • iicn-°''► 3
Address:2750 SW Edgarce St
City: Port St Lucie State: A
Zip Code: 34953 Fax:
Phone No 772-336-2448
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above]
E-Mail tdsac@aol.com
State or County License CAC035553
If value of construction is $2500 or more, a RECORDED Notice of commencement is requireda.
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 I MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
W.
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 l 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
With lonrlar nr an attnrnPv hPfore rommencine work or recordiniz vour Notice of Commencement.
N
Signature of Owner/ Le ee/C r for as Agent for Owner
Signature of Cont ctor/Li nse Holder
STATE OF FLORIDA
STATE 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 Preser�c or Online Notarization
this [ L day of ?% 20� by
this j day of 20�7,Plby
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
Notary Public- State of rida }
Notary Public- State of FI ida )
(Signature of
(Signature of
Com i 3 _ _ I}
of Florida
of Fwrtda al)
ComWREVIEW
Darnel F Stacey
ce
Expires p8r22l2U
RE
SUPERVISOR
PLAN
MANGROVE
COUNTER
REVIEW
REVIEW
REVIE
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/2U