HomeMy WebLinkAboutPermit App 4160 N Hwy A1A Unit 702AAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATI
Date: 10-15-21
TO BE ACCEPTED
Permit Number:
P LL COD ]J� ° ff) n Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commerci I X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 4160 N Hwy A1A Unit 702A
Property Tax ID #: 1423-506-0037-000-3
Lot No.
Site Plan Name:
Block No.
Project Name:
[DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 3.5 ton 14 seer 10 kw heat
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check z II that apply:
_Mechanical _ Gas Tank —Gas Piping Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ $4,700.00
Windows/Doors Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Marlene Bryant
ame: Shyan Wojtczak
Address: 4160 N Highway Al Apt 702A
ompany: Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _
Zip Code: 34951 Fax:
Phone No. 772-448-8899
ddress: 7901 Santana Ave
ity: Fort Pierce State: FL
ip 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)
-Mail coolairsol@gmail.com
�tate or County License CAC# 1819009
it value vT consirucuon is L-,)uu or more, a KECUKULLI Notice of Co mencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Comme cement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: — Not Appli
Name:_
Address:
City: _
Zip:
State
MORTGAGE COMPANY:
Name:
Address:
Citv:
Phone I Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
T Not Applicable
State:
Not Applicable
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 f Owner/ Les . tractor as Agent for Owner
Sign-iture.Df Contractor6iodinsh Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF `fit L�_,c1e
COUNTYOF L �_C_k
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 JkLday of 2020 by
this !�t'`day of C)cA 2020 by
Name of erson making tatement.
Name of erson making s atement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Pr duced
Pr uced
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(Signature of Notary Public- State of Florida }
(Signature of Notary Public- State of Florida )
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REVIEWS
FRONT
ZO
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PLANS
VEGETATI
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/15/210