HomeMy WebLinkAboutPermit App for 5710 Winter Garden PkwyAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9-8-21 Permit Number:
S�vo
P 11 ° Q ° ED) n Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 5710 Winter Garden Parkway
Property Tax ID #: 1301-613-0092-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 3 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: Sq. Ft. of First Floor:
Cost of Construction: $ $3,100.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Kimberly Peterson Name: Shyan Wojtczak
Address: 5710 Winter Garden Pkwy Company: Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _ Address: 7901 Santana Ave
Zip Code: 34951 Fax: City: Fort Pierce State: FL
Phone No. 772-913-2547 Zip Code: 34951 Fax: 772-801-5398
E-Mail: Phone No 772-634-0491
Fill in fee simple Title Holder on next page ( if different E-Mail coolairsol@gmail.com
from the Owner listed above) State or County License CAC# 1819009
If
If
value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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 your Notice of Commencement.
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SignatureOwner/ Lesi46yColiritractor as Agent for Owner
Signature -at Contractor/Len e_Hb I der
STATE OF FLORIDA
COUNTY OF_ � b_cie
STATE OF FLORIDA ,-
COUNTY OF 1 L
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this Lla day of 2020 by
, Physical Presence or Online Notarization
his day of 2020 by
Name of Verson making sttYtement.
Name of per making stament.
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Pr duced
PrQduced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida
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iev.5/b/20