HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATIO TO BE ACCEPTED
Date: 1-19-22 Permit Number:
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Building Pei mit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commerciol Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 8306 Coquina Ave
Property Tax I D #: 1301-608-0107-000-3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for like AC changeout 4 ton 14 seer 10 kw heat
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check a I that apply:
_Mechanical _ Gas Tank _ Gas Piping Shutters
_ Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ $3,900.00
. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: I _ Sewer _ Septic Building Height:
OWNER/LESSEE:
NameTravis & Charlene Carter
Address: 8306 Coquina Ave
City: Fort Pierce, FL State: _
Zip Code: 34951 Fax:
Phone No. 772-216-7697
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
ONTRACTOR:
ame: Shyan Wojtczak
ampany: Cool Air Solutions of Florida, Inc.
ddress: 7901 Santana Ave
ty: Fort Pierce State: FL
p Code: 34951 Fax: 772-801-5398
lone No 772-634-0491
Mail coolairsol@gmail.com
or County License CAC# 1819009
If value of construction is 2500 or more, a RECORDED Notice of Co mencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commen ement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: T Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
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 ipnrlpr nr an nttnrnpv hpfnrp cnmmencine work or recordine your Notice of Commencement.
Signature�f Owner/ Les /Cdntractor as Agent for Owner
Signature Gf- ontractor/Li6e M' ,H Ider
STATE OF FLORIDA F, �
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STATE OF FLORIDA -,
OF 1' I C7
COUNTY OF , )� oc �
COUNTY I )l
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this 1'A,,day of . )C`C`N ,'2:9 by
this jSIDclay of , )pia "1 2029by
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Name o4erson making s .atement.
Name of person makiingg ement.
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Pr duced
Pr used
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
Commission No. al) Notary��,tStatq of
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