HomeMy WebLinkAboutBaker, Cindy - Notarized Permit Application 10152021All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/15/2021 Permit Number:
27.
° Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: A/C and Duct Change Out
PROPOSED IMPROVEMENT LOCATION:
Address: 7402 Ocala Ave, Fort Pierce, FI34951
Property Tax ID #: 1302-810-0040-000-9
Site Plan Name: LAKEWOOD PARK ADDITION NO 1- BLKB LOT 13 (OR 3202-2331: 3206-2569; 3209-892)
Project Name: A.0 Change Out
DETAILED DESCRIPTION OF WORK:
2 Ton split air conditioner system with 8kw electric heater and whole home duct replacement
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: $ 13140
Generator
Sq. Ft. of First Floor:
Lot No. 1
Block No. 13
Windows/Doors _ Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Cynthia L Baker
Name: Anthony Fenn
Address: 7402 Ocala Ave
Company: Assured Air Conditioning
City: Fort Pierce State:_
Zip Code: 34951 Fax:
Phone No. (772)501-3557
Address: 278 NE Surfside Ave
City: Port St Lucie State: FI
Zip Code: 34983 Fax:
Phone No (772)202-2005
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailanthony.fenn@assuredairconditioning.com
State or County License CAC1820274
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Not
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
Zip:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 lendeyQr an attorney before commencing work or recording your Notice of Commencement.
4Signat
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ignat of Contract-or/License Holder
STATE OF FLORID / ,
STATE OF FLORID -
COUNTY OF I.FJG�(%
COUNTY OF k
Sw to (or affirmed) and subscribed before me of
Swor (or affirmed) and subscribed before me of
P sical Presence or mine Notarization
p�cal Pres nc� a pr_ nline Notarization
this day of 202oby
this day of �F-^lltA�-cv�, 202f by
Name of person makin statement.
Name of person n-hking statement.
Personally Known OR Produced Identification +/
Personally Known OR Produced Identification
Type of Identificatio
Type of Identification
Produced <_
Produced
Rebekah Hoy
(Signal re of Notary Public- State of Fl*.rwil
(Signature of Notary Public- State of Flor
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