HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - f -7_9— �2 i Permit Number:
I ° * PF2N)1'! Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 8202 Kenwood Rd
Property Tax ID #: 1301-605-0334-000-4
Site Plan Name:
Project Name:
I DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 2.5 ton 14 seer 10 kw heat
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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:
Cost of Construction: $ 2,800.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David A Stewart Jr
Name: Shyan Wojtczak
Address: 8202 Kenwood Rd
City: Fort Pierce, FL State: _
Zip Code: 34951 Fax:
Phone No. 772-595-2865
Company: Cool Air Solutions of Florida, Inc.
Address: 7901 Santana Ave
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-801-5398
Phone No 772-634-0491
E-Mail:
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 App
Name:_
Address:
City:
Zip:
Phon
FEE SIMPLE TITLE HOLDER:
Name:_
Address:
City:
Zip:
MORTGAGE COMPANY: T Not Applicable
Name:
Address:
State: City: State:
Zip: Phone:
Not Applicable
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as inaicatea.
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
la,i+k 1n 4r r nr on 7ttr%mOV kc fnra rnmmPnring work or recordine vour Notice of Commencement.
VV ILII 1111mA -1
Signature of Owner/ Les/ o actor as Agent for Owner
Signature of ontractor/License Ider
STATE OF FLORIDA,,.,
COUNTY OF A LIC i
STATE OF FLORIDA
COUNTY OF l .yc ( �2
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
�--Physical Presence or Online Notarization
by
---Physical Presence or Online Notarization
this }`?day of 2020 by
this S_L`lday of ) +tLt , 2020
Name making statement.
Name of person making statement.
Personally Known V OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Pr duced
Pr uced
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
Commission No.�9(r al) Notary Pubtic state of
Fmi ion N otary PuWi'aRe of Florida
on
Atna1lda P Sander
My Commission GG
Amanda P Sanderson
11256 .� My cwivnission GG 211256
Of M1b
xpires
G 1%.
REVIEWS FRONT ZO I R
COUNTER REVIEW REVIEW
PLANS VEGETATI
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.