HomeMy WebLinkAboutPermit App for 4160 N Hwy A1A Unit 807AAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/7/21 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 4160 N Hwy AlA
Property Tax ID #. 1423-506-0049-000-0
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 5 ton 14 seer 10 kw heat
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
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ $4,900.00
_ Generator
Sq. Ft. of First Floor:
Lot No._
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name LOPEZ REAL ESTATE HOLDINGS LLC
Name: Shyan Wojtczak
Address: 8145 SE Old Plantation CIR
Company: Cool Air Solutions of Florida, Inc.
City: Jupiter, FL State: _
Zip Code: 33458 Fax:
Phone No. 561-601-5467
Address: 7901 Santana Ave
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No 772-634-0491
E-Mail: rafwa@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail coolairsol@gmail.com
State or County License CAC# 1819009
It 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.
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.
Signaturle of Owner/*e/Vontractor as Agent for Owner
Signature-bf Contractor/ Liken" P_P older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ' - 'L � ik e
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
'-----Physical Presence or Online Notarization
--physical Presence or Online Notarization
this' jlLday of Ju1 12020 by
this a!Lday of Jc_ i(_j 2020 by
J
-C
Name of person making slatement.
Name of person making statement.
IK",
Personally Known OR Produced Identification
Personally Known VOR Produced Identification
Type of Identification
Type of Identification
Prp,duced
Pr uced
(Signature of Notary Public- State of Florida
(Signature of Notary Public- State of Florida)
Commission No. �al Stt"f
't= Sand,�rl
F18f6MMi V, qw, otary Pine of Fionda
on ion N of Florida
Amanda
My Co
Am�a�hda P Sanderson
My c4,n�.a,,ris.si,.nn3G' 211256
my'.
oFro
o
Exi"rer, U41 bz
4
REVIEWS
FRONT
ZO
I R
PLANS
VEGETAT3
'0W
!A
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.