HomeMy WebLinkAboutPermit App for 6103 Tangelo DrAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9-17-21
Permit Number:
Building Pe milt 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:
/-% ICJJ. '`'""JJ' vIIva
Property Tax ID #: 3402-610-0385-000-8
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 3 ton 16 seer 5 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
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ $4,400.00
Generator
Sq. Ft. of First Floor:
X
Lot No.
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _Septic Building Heieht:
OWNER/LESSEE:
CONTRACTOR:
Name Barbara Carruth
Name: Shyan Wojtczak
Address: 6103 Tangelo Dr
Cbmpany:
I
Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _
Zip Code: Fax:
Phone No. 772-293-0593
A
dress: 7901 Santana Ave
C ty: 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 71;nn nr mnra n Dcrnoncn R, .:
E-Mail coolairsol@gmail.com
State or County License CAC# 1819009
---------- �• ..v��u nC-ILCIIICIIL IJ requlrea.
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:
T Not Applicable
Name:
Name:
Address:
Address:
State: City:
State:
City:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
— Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made zo omain a per ffni LU uu Lf M VVVI I a
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
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_�,.__�... I,. F., rv.r.nor�rin[s,a,nrie nr rprnrAina vnfir Notice of Commencement.
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with ienaer r ane ut, uIC 1 Ul III I I CI 1—.E,-
t
Signature bf Owner/ Lessee/, tra for as Agent for Owner Signature of ontractor/Licers Holder.
STATE OF FLORIDA , STATE OF FLORIDA.
COUNTY OF �`� 1 a �C_ � �' COUNTY OF
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization """Physical Presence or Online Notarization
this I h'-day of ''"> 5 2020 by this al] 1`'day of 2020 by
pp �,
Name erson making statement. Name of per§ar making statement.
Personally Known Iv/,*" OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Type of Identification
Pr duced Pr �uced .—
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Commission No. al) Notary Putrflc Stste of F0-fftmi ion N r otary Pu&Q, of Florida
^ Amanda P Sander O 256 :° ^ Amanda P Sanderson
my commission GG My G�,mmission GG 211256
xplres 41
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REVIEWS FRONT ZO I R PLANS VEGETATI
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.