HomeMy WebLinkAboutBrown, Charles - Permit Application 382022All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/8/2022 Permit N um ber:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ABC Change out With electric heat
PROPOSED IMPROVEMENT LOCATION:
Address: 8145 Hidden Pines Road, Fort Pierce, FI 34945
Property Tax ID #: 2323-701-0034-000-7
Site Plan Name: HIDDEN PINES ESTATESBLK C LOT 1 (1.02 AC) (OR 3485-2695)
Project Name:
DETAILED DESCRIPTION OF WORK:
5 ton air conditioner change out with 10kw electric heater. 14.25 SEER
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. 1
Block No. C
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: $ 5500 Utilities: —Sewer —Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Charles Brown
Name: Anthony Fenn
Address: 8145 Hidden Pines Rd
Company: Assured Air Conditioning
City: Fort Pierce State: _
Zip Code: 34945 Fax:
Phone No. (540)905-2473
Address: 278 NE Surfside Ave
City: Port St Lucie State: FI
Zip Code: 34983 Fax:
Phone No (772)202-2005
E-Mail: theladyofshalott@ yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail anthony.fenn@ assuredairconditioning.com
State or County License CAC1820274
• .-a. v1 a. V1141.1U1V11 IJ LJVV VI IIIV[ C, d RC%-umutu IVOLIce OT l.Ommencement Is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
_—Not
DESIGNER/ENGINEER: Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name:
Address:
_
Address:
City: State:
_
City: State:
Zip: Phone
Zip: Phone: _
FEE SIMPLE TITLE HOLDER: x 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 le r or an attorney before commencing work or recording r Notice of Commencement.
i
Sign o Contractor/Lic se Holder
Signat a of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLOR14A
COUNTY OF ST- LAkci e
STATE OF FLORIDA
COUNTY OF �5t . LA16e
Sworn to (or affirmed) and subscribed before me of
J Physical Presence or Online Notarization
this day of fV\,C —rc t-, 202.&aby
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Sworn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this I day of M O_(—C)Vi— 20W by
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification ✓
Type of Idertificaxion
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Personally Known OR Produced Identification
Type of Identification
Produced 1 J'0-( LA' (k,+1kM
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o otar Public- State of Florida
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(Signatur of Notary Public- State of Florida)
Commission No. (Seal) (Seal)
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