HomeMy WebLinkAboutSLC PERMIT BROWNAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/21/2019 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
PERMITTYPE: hvac change out
PROPOSED IMPROVEMENT LOCATION:
Address: 10661 ORANGE AVE EXT
Property Tax ID ##: 230980100010000
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Commercial Residential x
Replace existing 2.5 ton system with Ruud 2.5 ton 16.0 seer w/7kw heat
Models RA1630 & RH1T3617
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
Electric Plumbing — Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4000.00
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
NameJef#rey Brown
Address:10661 Orange Ave Ext
City: Ft Pierce State:��
Zip Code: 34945 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:
Company:Tracy D Steele Air Cond. Inc.
Address:2750 SW Edgarce St
City: Port St Lucie State: EI
Zip Code: 34953 Fax:
Phone No772-336-2448
E-Mailtdsac@aol.com
State or County LicenseCAC035553
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC 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 YOUR PAYING
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
�C_44__
Signature of Ow / Les4gaeontractor as Agent for Owner
Signature of Contr or/ " " se Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF st Lucie
COUNTY OF St Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 21 day of May 20a by
this 21 day of May 20J� by
Tracy D Steele
Tracy D Steele
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
Produced
Produced
(Signature of Notary Public- State of Florida)
[Signature of Notary Public- State of Florida j
Commi
C � N9%otary StaleFlorida (Seal)
Notary Public State oI Florida
Stacey
Daniel F Stacey
Ma Commission 1
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