HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6-29-21
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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 X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 4180 N Highway fk I.Ax
PropertyTaxlDt 1423-506-0126-000-4
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 3.5 ton 14 seer 10kw heat
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential
Lot No.
Block No.
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: Sq. Ft. of First Floor:
Cost of Construction: $ 4,200.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Anthony & Anna Nocera Name: Shyan Wojtczak
Address: 17 Broad Oak Lane Company: Cool Air Solutions of Florida, Inc.
City: Dix Hills, NY State: Address: 7901 Santana Ave
Zip Code: 11746 Fax: City: Fort Pierce State: FL
Phone No. 646-423-0327 Zip Code: 34951 Fax: 772-$01-5398
E-Mail: Phone No 772-634-0491
Fill in fee simple Title Holder on next page 'if different E-Mail coolairsol@gmail.com
from the Owner listed above) State or County License CAC# 1819009
If
value
of
construction is
2500 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 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.
Inconsideration 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 fades and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: raarri additions,
accessory structures, swimming pools, fences, walls, signs, screen roams and accessory uses to another non-residential use
WARNING TO OWNEM, Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement mush 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 (ender or an attorney before commencing work or recordine yqur Notice of Commencement.
AZT
Signatu4of Owner/ Le'.��e6/c6ntractor as Agent for Owner Signatu4~ of Contra ctort i-cens alder
STATE CIF FLORIDA STATE OF FLORIDA
ofCOUNTY of�)v
COUNTY
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
4�-~-Thys'ica1 Presence or Online Notarization '.------'Physical Presence or _online Notarization
this mLay of _ . � �.�: -e��`_ , 2020 by this ;�.;�..:�.`�1ay of _ � t.__ -`�=�� , 2020 by
Name of erson making statement. Name of per on making sfa3#ement.
Known roe�� OR Produced Identification Personally Known V/O/P"
OR produced Identification
Personally
Type of Ident'ification Type of identification
Pr duced Pro aced
0,
MEN_
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida j
No.oft-0. al) c� P„�,c Maceof"�mi ion N Y eta Pu�9�ae t�f FlCiricla
Commissionxo�`�� Amanda P S2ind�2ron �� :° Am� t�a P Sanderson
• � My Cc,�r�mission GG 11 � 4 �t My Currvn'sssiart GG 211256
or �� )Ttrj
t xpN^4 I AIL.
ov!'Ilioi
�r s
REVIEWS FRONT zo 11 R PLANS VEGETATI
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPL-ET-ED
Rev. 5/6/20