HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/24/21
Permit Number:
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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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
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Residential X
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Property Tax ID #: C,� _ � (mac C, Lot No.
Site Plan Name:
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 3.5 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 _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ $3500.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Heieht:
OWNER/LESSEE:
CONTRACTOR:
Name Rick Smith
Name: Shyan Wojtczak
Address:5101 Sunset Blvd
Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _
Zip Code: 34982 Fax:
Phone No. 772-293-1407
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)
If value of construction is 2snn nr mnrc � Dcrnencn hi—i__ _r
E-Mail coolairsol@gmail.com
State or County License CAC# 1819009
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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
Name:_
Address:
City: _
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
Citv:
Zip: Phone. -----
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the wom ana installation as 1nolcateu.
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
...;+L. I....,.J.,..,. "n ni•i-nrncknfnnn rnr„mPnrina wnrk nr rQcnrdine your Notice of Commencement.
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S gnature)of owner/ Le,' e' C tractor as Agent for Owner
Signature Contractor/Lds Ider
STATE OF FLORIDA
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STATE OF FLORIDA
COUNTY OF L 'i
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
tom -Physical Presence or Online Notarization
'-`-- Physical Presence or Online Notarization
this - l�ay of AVC•C. 2020 by
this` q�',day of [_ 2020 by
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Name of/person making statement.
Name o'Orson making statement.
Personally Known OR Produced Identification
Personally Known i' OR Produced Identification
Type of Identification
Type of Identification
Pr duced __
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(Signature of Notary Public- State of Florida
(Signature of Notary Public- State of Florida)
Commission No. a�l) Notary Public State of
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