HomeMy WebLinkAboutGregory, Monica - Permit Application 10262021All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/26/2021 Permit Number:
9 V 0 ° a Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: A/C and Duct Work
PROPOS„IJk)PRQWIutE,N f LOGPTIOGU,
Address: 630 Kearney Road, Fort Pierce, F134982
Property Tax I D #: 3410-601-0016-000-8
Site Plan Name: WHITE CITY ESTATESBLK 1 LOT 12 AND 13
Project Name:
A/C change out with 10kw electric heat and whole home duct
Lot No. 12 & 13
Block No. 1
New Electrical Meter Second Electrical Meter
CO�1TRlCTION 1NFCfCih/IATIONYu
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 14,650 Utilities: _Sewer _Septic Building Height:
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Name Monica Gregory and Miller Gilstrap
Name: Anthony Fenn
Address: 630 Kearney Road
Company: Assured Air Conditioning
City: Fort Pierce State: _
Zip Code: 34982 Fax:
Phone No. (317)850-4534
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@assuredaircorditionlng.com
State or County License CAC1820274
If value of construction is 2500 or more, a RECORDED Notice of commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
cable I MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable I BONDING COMPANY: _Not Applicable
Name:_
Address:
City: City
Zip: Phone: Zip:
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 Count
yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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.
lgna re c w ie(r Lessee/Contractor as Agent for Owner
ignatur f Contr—aCtoryLicense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF /�
COUNTY OF��iLG
Sword to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Phyyical Presence one Notarization
ical Presence of �Online Notarization
2020 by
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Name of person makig statement.
Name of person m 1ng statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identificationd
Type of Identification
Type of Identific n
Produced
Produc d
(Signature of Notary Public- S tg' 1prida) CAi neRINe A�+riNM�N
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REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/20
ig, 2022
oilyAssn.