HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12 / 812021
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Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 13300 NW MAPLE WOOD RD PALM CITY FL 34990
Property Tax ID #: 4426-815-0050-000-7
Site Plan Name:
Project Name:
Permit Number: '4 f / 2
Building Permit Application iZoz 6 0 �o
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DETAILED DESCRIPTION OF WORK:
AC CHANGE OUT LIKE FOR LIKE 3.5 TON 16 SEER R410A 10KW HEAT " ATTIC LOCATION "
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:: 669G'
Cost of Construction: $ 6C 0 7
Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: 4a�._�.....:, .,
Name STEPHEN KISS
Name: DAVID T SMITH JR
Address: 13300 NW MAPLEWOOD DR
City: PALM CITY FL State: _
Zip Code: 34990 Fax:
Phone No. 561- 714- 5637
Company: ONE CALL AIR CONDITIONING
Address: 968 SW PROVINCETOWN LANE
City: PORT SAINT LUCIE State: FL
Zip Code: 34953 Fax:
Phone No 772-201-3885
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail ONECALLCOOLING@GMAIL.COM
State or County License CAC1817403
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:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 IwWer orzVittbrnev before commencing work or record. m your Np ij;e of Commencement.
re of Owner/ LesseejContractor as Agent for Owner
STATE OF FLORIn
COUNTY OF
Swor or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced bi Of
(Signature of Notary Public- State of Florida )
Commission No.
(Seal)
ctor/License Holder
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No.
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DATE
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