HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/08/2021 Permit Number:
1'7
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: hvaC Change out
PROPOSED IMPROVEMENT LOCATION:
Address: 9644 Crooked Stick Ln. PSL 34987
Property Tax ID#: 332771100080002 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace existing 5 ton system with Goodman 5 ton 16.0 seer w/10kw heater
Models GSX16060&ASPT61 D
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: Sq. Ft. of First Floor:
Cost of Construction: $ 5000.00 utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Theresa Corderi Name: Tracy Steele
Address: 10379 SW Watereway Ln Company: Tracy D Steele Air Conditioning Inc
City: Port St Lucie State:V,� Address:2750 SW Edgarce St
Zip Code: 34987 Fax: City: fort St Lucie State:El
Phone No.973-513-5628 Zip Code: 34953 Fax:
E-Mail: Phone No772/215/1974
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 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 Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: 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 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 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 attorney before commencing work or recording our Notice of Commencement.
L
Signature of Owner/L sse6/Contractor as Agent for Owner Signature of Contractor Li ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCiF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
x Physical Presence or Online Notarization X Physical Presence or Online Notarization
this day of e ,:r_ ,2020 by this day of y r�i_ 2020 by
TRACY D STEELE TRACY Q 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-St t f i r" (Signature of Notary Public-State ofFlorida )
CommissiK. Expires
CNotary of Fioride
(Seal) Commis9'rr
WAA
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mission GG 251653
08122/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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COMPLETED
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