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Daft.061021?O21 permit Number
STLUGNE
Building Permit Application
Plonning ond Development SeNices
Building ond Code Regulotion Division
2j00 Virginio Avenue, Fott Pierce FL U982
Phone: (7721 462-1553 Fax: 17721462-1578
Com mercia I Residential x
PERMITAPPLICATION FOR: HVAC CHANGE OUT MECHANICAL
Address. 116 PEPPER LANE
Property 1.* 19 6. 451 1-503-0024{00-9 Lot No. 18
Site plan Name: BAY TREE Block No. _
HVAC CHANGEOUT NO DUCT WORK, CARRTER 15.5 SEER, 2.5 TON, 8 KW ( FV4CNF003L00 , 24ACA430C003)
Ada, 1t'?zqna
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit - check all thatapply
F Mechanical _ Gas Tank
Electric _ Plumbing
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Windows/Doors
Roof
Pond
Pitch
Total 5q. Ft of Construction;
Cost of Construction: S 6464.00
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height: _
N3mg Walter R Paul & Martha L Paul
Address: 116 PEPPER LANE
phone No. 772-233-9408 Fax:
g-vt3;1. BEACHBUMS@COMCAST.NET phone No 561640-1000
g-tvl3;1 PERMITS@KYZARAIRCONDITIONING.COM
Fax
Company . KYZAR AIR CONDITIONING INC.
City . Jensen Beach
zip 6s6g.34957
State or County f-i6g.5s CAC'1814778
zip gs6g. 334 13
Address
t16ms. DAVID KYZAR
State: z_
WEST PALM BEACH
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
City:
It value of construction is 2500 or more, a RECORDED Notice of Commencement ls requlred.
ll value of HAVC is 57,500 or more, a RECORDED Notice ofCommencement is required.
' L i] II I rj :,
PROPOSED I MPROVEMENT LOCATION:
Pr.i".t Nr-o'
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
OWNER/LESSEE:CONTRACTOR:
239 TALL PINES ROAD
State: FL
M;/L >,.2r-\-
Sfti-ature of owfier/ tesse/cS'tractor as Agent for owner si gnature of Contractor/License Hol
STATE OF FLORIDA
COUNTY OF PALM sEAcr.i
STATE OF FLORIDA
COUNTY OF PArM BEACFT
Sworn to (or affirmed) and subscribed before me of
L Physical Presence or _ Online Notarization
Sworn to (or affirmed) and subscribed before me ofx Physical Presence or _ Online Notarization
this _L day Of JUNE 202C by this _L day o1 Jtrr\a 2020 by
Name of person making statement.
Personally Xnown _ OR Produced ldentification _
Type of ldentification
Name of person making statement
Personally (nown _ oR Produced ldentification _
Type of ldentification
Produced Produce
(Public- St a VICENTI Y LE^L (Public-
rlot.ry Publi..St tr of VICEXTE Y IE L
(6E4l lubri( - St.!. of Fcommission No,I omm i5rion i{H 0 l 95 mission No(omm Expi re5 sep l Commt HH 0 3 95Eo.d.d lhrolth N.tioo.l Notiry tr
Not.ry
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLAN S
REVIEW
VEGETATION
REVIEW
s
REVIEW
Com
REVIEW
79
DESIGNER/ENGINEER:
Name:
_ Not Applicable
City:State:
Address:
Phone
MORTGAGE COMPANY:
Name:
_ Not Applicable
State:City:
zip:
Address:
FEE SIMPtE TITLE HOLDER: _ Not Applicable
Na me:
zip:
Address:
Phone:
BONDING COMPANY:
Name:
_Not Applicable
City:
zip:
Address:
Phon e
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 Countv makes no reoresentation that is Erantinp a oermit will authorize the oermit holder to build the subiect structure
which is in conflict with anv aoolicable Home owiers Asiociation rules. bvlaws or and covenants that mav restrict 6r Drohibit such
structure. Please consult with iour Home Owners Association and revi6w'your deed for any restrictions uihich may afply.
ln 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 5t. Lucie County Amendments.
The following building permit applications are exempt from undergoinB a full concurrency review: room additionS
accessory structures, swimminS pools, fencet 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. lf you intend to obtain financing, consult
with lender or an attorn before commenci work or recordin our Notice of Co mencement.
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MANGXOVT-
SUPPLEM ENTAL CONSTRUCTION LI EN LAW I NFORMATION:
Zip: _Phone:
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