HomeMy WebLinkAboutBuilding Permit Application AC change out.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/14/2021 Permit Number:
'Liz i L�-L
I_' i (, `' ` Ll Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FORA/C Change Out - No duct work
PROPOSED IMPROVEMENT LOCATION:
Address: 5647 Sunberry Cir, Fort Pierce FL 34951
Property Tax ID #: 1312-502-0173-000-5 Lot No.
Site Plan Name: Block No.
Project Name: A/C Change Out - No duct work
DETAILED DESCRIPTION OF WORK:
A/C Change Out - No duct work
5 TONS - CARRIER - SEER 16 - 10KW HEATER
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 _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:.
Cost of Construction: $ 3600
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Pascualina Fodor
Name: Karen Oliver
Address: 5647 Sunberry Cir
Company: AAA A/C QUALITY SERVICES
City: Fort Pierce State: L
Zip Code: 34951 Fax:
Phone No. 5615437184
Address: 126 Valencia St
City: Royal Palm Beach State: FL
Zip Code: 33411 Fax:
Phone No 8005069429
E-Mail: PPfodor@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail aaaacqualityservices@gmail.com
State or County License CAC1818921
It value of construction is ZSQD or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: _
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:_
Address:
City: _ State:
Zip: _ Phone
City: _ _ _State:
Zip: Phone: _
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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
with lender or an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signat re of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SAINT LUCIE
COUNTY OF SAINT I uclE
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 t4 day of JUNE 2021 by
this 14 day of •TUNE 2020 by
KAREN OLIVER
KAREN OLIVER
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
Pr uced
Pro uced
Ott ri Notary Public State of Florida
Beatriz Beretervide 9
NotarY Public State of Florida
,p`'r Beatriz Beretervide
244869
(S e oM.n5���(Seah)
(Si ture iliCE �PI3PY3a )
Commission
Com fission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 20