HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAlt APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9-1-21 Permit Number:
ding-Permit-App
Planning and Developrrlent Services
Building and Code Regulation Divislon Commercial
2300 Virginia Avenue, Fort Pierce FL 94982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITAPPLICATlON FOR;
Residential X
Address:
azts camppeu ra
2309-433-0000-000-4 IntNn
Property Tax ID 9:
Site Plan Name:
Project Name: ibtesam saleh
LIItt t'VI'C LIn.0 wV �. nhtIVUC vV I
New Electrical Meter Second Electrical Meter_
Additional work to be performed under this permit —check all that apply:
Mechanical _Gas Tank Gas Piping _Shutters
Electric _Plumbing _sprinklers _Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 6648.00
Block No.
Windows/Doors _Pond
Roof Pitch
Sq. Ft, of First Floor:
Utilities: Sewer _Septic BuildingHeight:
Name ibtesam saleh
Address: 928 Campbell rd
City: JqTLgjerce State: F
Zip Code:34945 Fax:
Phone No.954-655-7130
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
company: Sea Coast A/C and Sheet Metal Inc.
Address;
city: 3108 Industrial 31st Street
Ft Pierce state: FL
code: 34946 Fax: 772-448-4416 No 772-466-2400
Mail info(a s aacoastair com
zip
Phone
E-
State or County License CMC035421
encement Is regc
If value of construction is 2500 or more, a RECORDED Notice of Comm
If value of NAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
IRPLMI�IPI CONST}UCTIQ'(gN,LAUI INFo_RIy1A�ION
ITT
DESIGNER/ENGINEER: d _ Not Applicable
_ ., x� y
MORTGAGE COMPANY: _ Not Applicable m
Name:
_
Name:
Address:
Address:
City:
_ZjP:__-- —Phone:-----
_State:
_.._ --
City: _ State:
ZI 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 ao the work an❑ insieuauuu do 11 �uILa�=ul
i certify that no work of installation has commenced prior to the Issuance of a permit.
St. Lucie Coon {fyI makes noyi epresentation that is granting a permit will authorize the permit holder to build the subject structure
st{hucturenPlease eonsult wlthpyou Hoine Owners Owners
tapd review your deed for any restrictions which wi,ichtmay apply Ibit such
n-consideration of the of this requested.permit, I do hereby agree that Lwill, Ina.11 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 Stt
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorneybefore commencin work orrecording our No ice of Commencement.
1 il 4 a/
Signature of Owner/ Lessee/Contractor as Agent For Owner
STATE OF FLO I P
COUI`k OF M �lo•e
S rn to (or affirmed) and subscribed before me of
Physical Presence or online Notarization
this 1 day of Sept , 202( by
Name of person m king statement.
Personally Known � OR Produced Identification
Type of Identification
Produced
ignature of Notary Public of Florida )
Commission No.�aL. (Sealtit)
yf�l
JUSTINAI HOPKINSCONNELL
W
REVIEWS ErONTI PIRE4 G� 3
t Aim
uH.
STATE OF FLOE l�A i C,t �-
COUNTY OF �
S onto (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this A_ day of Sept , 2021 by
Chn% he,� 1 &nge� ( —
Name of person making statement.
Personally Known X oR Produced Identification
Type of Identification
of Notary Public- State9of Florida
NS VEGETATION
EW REVIEW
WrOT61T14rhfolul
AHRI Certified Reference Number : 9830413 Date : 08-31-2021 Model Status :Active
AHRI Type : RCU-A-CB (Split System: Air -Cooled Condensing Unil, Coil with Blower)
Series: 14 SEER W SERIES R410A AC
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Outdoor Unit Model Number (Condenser or Single Package) : WCA4484GKA**
Indoor Unit Model Number (Evaporator and/or Air Handler) : WAPL484A*
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2021Atr-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 13274909937e475595