HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/29/2021 Permit Number:
c DO 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
PERMIT APPLICATION FOR:HVAC/Mechanical
PROPOSED IMPROVEMENT LOCATION:
XX
Address: 7661 McClintock Way Port Saint Lucie, FL 34952
Property Tax ID #: 3424-800-0069-000-8 Lot No. 17
Site Plan Name: Griffith Block No. 69
Project Name:
DETAILED DESCRIPTION OF WORK:
Exact AC change out, no duct work
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit —check all that apply:
x Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4,770.79
_ Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: --Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Fred Griffith
Name:James R. Nichols _
Address: 7661 McClintock WT _
Company: Speedy Air Conditioning Service
City: Port Saint Lucie State:
Address: 532 NW Mercantile PI, Unit 111
Zip Code: 34952 Fax: N/A
City: Port Saint Lucie State: FL
Phone No. (860) 919-3693 E-
Zip Code: 34986 Fax:772-934-3511
Phone No 772-871-1560
Mail: griffithfred(d)-sbcglobal.net _
Fill in fee simple Title Holder on next page (if different
E-Mail Perm itting(speedyacservice.com
from the Owner listed above)
State or County License CAC1820639
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:
R:
Name:
Address:
City:
Zip: Phone
Not Applicable
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: _
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name: "—
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City:
ZIP: Phone:
Not Applicable
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu t 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 an ted o he ' site before the first inspection. If you intend to obtain financing, consult
with lender an atto a fore commencin w k d'
152 or or recor In your Notice of Commencement.
Signature of Ow ntra for as Agent for Owner
STATE OF F ORI
COUNTY O
Swgo (or affirmed) and subscribed before me of y__ Physical Presence or Online Notarization
this day of nr ifYlbi2ir 20LA by
:1—C _knr�e -�� n1 \ c
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature o Notary Public- State ofFlorida)
Commission No. V �Pu►1 -1 -5 !(Seal)
Notary PubW Sbty of pwkda
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REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
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COMPLETED
Rev 5120/21