HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/13/2021 Permit Number:
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` 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
LROPO
ITAPPLICATION FOR:A/C Change Out
SED IMPROVEMENT LOCATION:
Address: 6660 Campanella Fort Pierce, FI 34951
Property Tax ID#: 1306-500-0242-000-5 Lot No.53
citn Plan IVama• .H Block No. 12
ProjectName: SPANISHLAKIES FAIRWAYSBLK 53 LOT 12 (OR 3192-941; 3608-2728)
LbETAI LED D ESCRI PTI ON OF WORK:
Like for like ac change out.
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 _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 4110
Sq. Ft. of First Floor: _
Utilities: _sewer Septic
Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
N a m e 0 h risti an Chessman
Name: Anthony.Fenn
Address. 6660 Campanella
Company: Assured Air Conditioning
City: Fort Pierce State: _
Zip Code: Fax: 34951
Phone No.
Address: 278 NF Surfside Ave.
Cl St Lucie State: FI
Zip Code: 34983 Fax;
Phone No 7722022005
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail anthony.fenn@ assuredairconditioning.com
State or County License CAC1820274
If value of construction is 2500 or more, a RECORDED Notice of commencement Is requlrea.
If value of i is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: 7Applicable
Name:
Name:
Address:
Address:
City: State^
City:
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 Ass ,ciation 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,.: 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 fro n undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, sign., screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a N tice of Commencement may result in paying twice for
improvements to your property. A Notice ofCommencement must be recorded in the public records of St.
Lucie County and_posted on the jobsite befo e the first inspection. If you intend to obtain financing, consult
with lender or ttorney before commencin work or recoidin ur d ice of Commencement.
Signature of Ow er/ Lessee tractor as Agent for Owner
Signature of Cc9tractor/License Holder
STATE OF FLOR
COUNTY OF I C44
STATE OF FLORICIA
COUNTY OF S , L-IkGt C-
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Swo n to (or affirmed) and subscribed before me of
Ph sical Prese ce orOnline Notarization
y
this day of Yk (D nwd A . 2024 by
Sworn to (or affirmed) and subscribed before me of
✓y h sical Pres rice or Online N tarization
this day of �P cRm hu , 202� by
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Name of person makings tement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
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Type of Identifi ion
Produced L
Type of Identi tigon.�
Produced tJ �-
(Signature o No
.;�r'i'•, PETRONA E AN
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Commission No. _ ( f
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Hotar Assn.
(Signature of Notary Public-
Commission No.
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[g0�P{ ssion Y HH 010287
, rM1.%' My(nfM!Explres Jun 14, 202
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