HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02/02/2022 Permit Number:
Building Permit 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
Commercial Residential X
CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 3175 Columbrina Cir, Port St Lucie, FI 34952
Property Tax ID #: 342570200210002 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Install Daiken 2 ton 17 seer mini -split
Models RXB24AXVJU & FTXB24AXVJU
New Electrical Meter Second Electrical Meter
(Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
XMechanical _ 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: $ 4000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Robert Day
Name: Tracy D Steele
Address: 3175 Columbrina Cir
Company: Tracy D Steele Air Conditioning Inc
City: Port St Lucie State: FI
Address: _ 2750 SW Edgarce St
Zip Code: 34952 Fax:
City: Port St Lucie State: F]
Phone No. 772-336-0177 E--
Zip Code: 34953 Fax:
Mail: lampsbyday@aol.com
Phone No 772-336-2448
Fill in fee simple Title Holder on next page (if different
E-Mail tdsac@aol.com
from the Owner listed above)
State or County License CAC035553
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:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: ` Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
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 conflicts with an 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
with lender or an attorney before commencin work or recordin our Notice of Commencement.
Signature of Contractor - r -(awrfer 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 , � day of 2022 by
Tracy D Steele
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification Produced
�t
(Signature of Notary Public- State of F orida)
Com
o,�Ir Notary Public State v! Florida
+ Daniel F Stacey
- l My Cammissmn GG 251653
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION 5EATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED