HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
01 /4/22 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMITAPPLICATION FOR
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5407 citrus ave
Address:
3409-502-0001-010-5 Lot No.
Property Tax Intl:
Block No.
Site Plan Name:
Project Name: ralph Fogg
LIKE FOR LIKE AC CHANGE OUT 3 ton, 16 seer, 10 kw
New Electrical Meter Second Electrical Meter. (Affidavit required)
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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: $ 6950.00 Utilities: _Sewer Septic Building Height:
gWNER/LES�E CQNTRAC70R
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Name ralph Fogg Name: Christopher Langel
Address: 5407 citrus ave _ Company: (;naet q/C an
fort pierce State: fl Address: 3108 INDUSTRIAL 31 ST STREET
city:
Zip Code:34982 Fax: City: FT PIERCE State: FL
772-201-7312 E- Zip Code: 34946 Fax: 772-4484416
Phone No,
Mall: Phone No 772-466-2400
Fill in fee simple Title Holder on next page (if different E-Mail INFO@SEACOASTAIR.COM
from the Owner listed above) State or County License CMC0a5421
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.
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DESIGNER/ENGINEER: _ Not Applicable
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MORTGAGE COMPANY: — Not Applicable
Name:
Name:
_
Address:
Address:
City;
Zip: Phone
State; _
City;
Zip: Phone:
State:
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.
certify that no work or Installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is grantingg a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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
tith Ipnrlpr nr nn artnrnpv hpfnrp cmnmencine work or recordine your Notice of Commencement,
Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF ST LUCIE
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this 4 day of January 2022 by
CHRISTOPHER LANGEL
Name of person making statement,
Personally Known _ X OR Produced identification
Type of Identification Produced
L�� o C>��� 2 � ILL h 0 �
( nature of Notary Public-Stateo Florida)
:;aiNY°Noof JUSiINAL,HOPKINSCONNELLY
Commission NoGjgq�,��uLr�$eal)
'1 ;� MYCOMMISSIONN00940602
o` 4PIRES:Doo8rob9117,2023
'�`P,f,.t,S` llondWhniNotaryPublic Undewdters
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Rev 10/12/21
Eligible for Federal Tax Credit
AHRI Certified Reference Number : 201384313 Dale : 12-31-2021 Model Status :Active
Old AHRI Reference Number : 8242079
AHRI Type: RCU-A-CB (Split System: Air -Cooled Condensing Unit, Coil with Blower)
Series: GSX 16
Outdoor Unit Brand Name: GOODMAN
Outdoor Unit Model Number (Condenser or Single Package) : GSX160361 F*
Indoor Unit Model Number (Evaporator and/or Air Handler) : ASPT47D14A*
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02021 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 3za54za5ssso33143