HomeMy WebLinkAboutPermit App for 4900 Indrio Rd.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9-20-21 Permit Number:
giro
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l� L o c° 77 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:
A - 1
Address: - uvv uiuiw rw, run Fierce
Property Tax ID #: 1418-244-0040-000-8
Site Plan Name:
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:
lit
Lot No._
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors Pond
_ Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ $4,500.00
Sprinklers Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Leonard Maniscalco
Name:
Company:
Zip
E
S
Shyan Wojtczak
Address: 4900 Indrio Rd
Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _Address:
Zip Code: 34951 Fax:City:
Phone No. 954-609-5064
7901 Santana Ave
Fort Pierce State: FL
Code: 34951 Fax: 772-801-5398
hone 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 rnncrnir+inn is -3cnn -, ,,.,
Mail coolairsol@gmail.com
ate or County License CAC# 1819009
— -- - --•-•-i w6wc U1 wiiruiCncernen1 Is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION,
DESIGNER/ENGINEER:
Name:
V Not Applicable
MORTGAGE COMPANY:
Name:
T Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER:
Name:
Address:
_ Not Applicable
BONDING COMPANY:
Name:
Not Applicable
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao the wur k di lu 16SUs ia10" aS ,.,4,��� w•
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
structure. Pleas'econsultwith pyolurHlomeOwners Association and review your deed for covenants
ny restrictions which may aprohibit such
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,,,f,,.- , ,,�,, ,orrine Wnrle nr rarnrriina vnur Notice of Commencement.
with lenuef vt an a mwi i e uci vi c a v i n i . .. ... ...
—•• • _ -- - - -
CLAZ
Signature of Owner/ ,L ss /Contractor as Agent for Owner
Signature,of Contra ctbrpL' e` e Holder
STATE OF FLORIDA
STATE OF FLORID
-
COUNTY OF Iv � se
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 . day of -� ' 3 i , 2020 by
this <a- )` --day of ,C"�;� t 2020 by
c v
�"_ .
Name of- erson making statement.
Name of erson makin tatement.
Personally Known )l-**,- 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 Florid�/ac�)
(Signature of Notary Public- State of Florida)
Commission No. �_ al) Notary Public State of
Ftftmi ion N� r otary Pub4i�Qe of Florida
,4 r Amanda P Sander
�y Comm�ss�on GG
on :� n Amanda P Sande, rson
11256 My cunifnission GG 211256
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Of M J
xpu'es
O M1
REVIEWS FRONT ZO I R
COUNTER REVIEW REVIEW
PLANS VEGETATI
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DOTE
Rev.5/6/20