HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1-12-22 Permit Number:
Building Pe "mit Application
Planning and Development Services
Building and Code Regulation Division Commerci I X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 3225 South Lakeview Circle #205
Property Tax ID #: 1426-501-0059-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 2.5 ton 14 seer 5 kw heat
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check z II that apply:
_Mechanical _ Gas Tank _ Gas Piping Shutters _ Windows/Doors Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ $4,100.00 Utilities. —Sewer _ Septic Building Height:
OWNER/LESSEE:
ONTRACTOR:
Name Sharon Rogers
Name: Shyan Wojtczak
Address: 3225 South Lakeview Circle #205Company:
Cool Air Solutions of Florida, Inc.
City: Fort Pierce, FL State: _Address:
Zip Code: 34949 Fax:City:
Phone No.
7901 Santana Ave
Fort Pierce State: FL
A.ip Code: 34951 Fax: 772-801-5398 s
hone No 772-634-0491
E-Mail: sharon33371@earthlink.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail coolairsol@gmail.com
State or County License CAC# 1819009
-I VOIUC v1 4.vnaL1uu1V11 is cz)vv or more, a KrLUKUtu Notice or co mencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Comme cement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: T Not Applicable,
Name:
Name:
Address:
Address:
City: State:
Zip: Phone—
City: State:
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 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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this _ day of 12020 by
— Physical Presence or Online Notarization
this _ day of 2020 by
Name of person making statement.
Name of person making statement.
Personally Known %/ OR Produced Identification
Type of Identification
P duce Pr
Personally Known V/1" OR Produced Identification
Type of Identification
Pr uced
Signature of Notary Public- State of Florida
State of Florida)Ilo
(Signature of Notary Public- State of
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Commission No. PAC,411 al) NOWY PUbilC State
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