HomeMy WebLinkAboutPermit App 4250 N Hwy A1A Apt 1107All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10-3-21 Permit Number:
ST Luci
O(.INT�..
O R 1 A
Building Perjmit Application
Planning and Development Services
Building and Code Regulation Division Commerciz 1
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 4250 N highway A1A Unit 1107
Property Tax ID #: 1423-501-0087-000-3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 2.5 ton 14 seer 5 kw heat
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
X Residential
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: $ 4,200.00
Sq. Ft. of First Floor:
Lot No._
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jorge & Marie CalixtoName:
Shyan Wojtczak
Address: 3635 SW 139th Place
Company: Cool Air Solutions of Florida, Inc.
City: Miami, FL State: _Address:
Zip Code: 33175 Fax:
Phone No. 305-778-6182
7901 Santana Ave
ity: 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)
-Mail coolairsol@gmail.com
State or County License CAC# 1819009
it value oT consirucxion is LSUU or more, a KLCUKULU Notice of Co mencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commen, ement 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.
Signatur of Owner/ Leis ntractor as Agent for Owner
Signatur f Contractor/ i se older
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OFF �-t
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
---- Physical Presence or Online Notarization
this 3'cl day of ( '_ l C ( 12020 by
-- Physical Presence or Online Notarization
this aL"1 day of ( %C'tZ015Fr 2020 by
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Name ofperson making statement.
Name of p son making statement.
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Pr duced
Produced
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
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