HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/02/2021 Permit Number:
IM
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
PERMIT APPLICATION FOR: hvaC Change Out
PROPOSED IMPROVEMENT LOCATION:
Address: 29 Lake Vista Trl. U-101, PSL, FI 34952
Property Tax ID #: 342250003930001
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace existing 2 ton system with Rheem 2 ton 16.0 seer w15kw heat
Models RA1424 & RH1T2417
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential x
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: $ 4000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE. CONTRACTOR:
Name Steven Oostdyk Name: Tracy Steele
Address: 29 Lake Vista Trl U-101 Company: Tracy D Steele Air Conditioning Inc
City: Port St Lucie State: FL Address:2750 SW Edgarce St
Zip Code.. 34986 Fax: City: Port St Lucie State: FI
Phone No. 772-577-9322 Zip Code: 34953 Fax:
E-Mail: Phone No772121511974
Fill in fee simple Title Holder on next page ( if different E-Mailtdsac@aol.com
from the Owner listed above) State or County License CAC035553
If vahip of rnnCfrnrf Enn - 3rnn
-- ---- -- ..._. — — — ni nanc.enIeni 15 regUfreQ.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION: LIEN
LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Marne: —
MORTGAGE COMPANY: Not Applicable
Address:
Name:
City:
Address:
State:
Zip: Phone
City:
State:
Zip: —. Phone:
FEE SIMPLE TITLE HOLDER; Not Applicable
Name:
BONDING COMPANY:
Address:
Not Applicable
Name:
City:
Address:
Zip: Phone:
City:
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 su
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may aply, ch
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 attorne before commencin work or recording your Notice of Commen
Signature of Owner/ Less fe/C tr tar as Agent for Owner
STATE OF FLORIDA
COUNTY OF STLUCIE
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this z day of August
2D2 ja by
TRACY ❑ STEELE
Name of person making statement.
Personally Known x OR Produced Identification
Type of identification
Produced
{Signature of Notary Public State of Florida )
CommISSICYt+�lrs.,r►.. _ � _ _ _ ,.. ..
REVIEW.^
DATE
RECEIVED
DATE
COMPLETED
Notary > ubfic State of Ronda
cement.
C�
Signature of Con acto / cerise Holder
STATE OF FLORIDA
COUNTY of STLuciE
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online P.-tarization
this 2 day of August 2G2l by
TRACY D STEELE
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
{Signature of Notary Public- State of Florida )
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