HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/24/19 Permit Number:
SCANNED
BY RECEfVED
• St. LUCie County
Building Permit Application OCT I ears
Planning and Development Services ae RBng department
Building and Code Regulation Division
t Lude County
2300 Virginia Avenue, Fort Pierce FL 34982
—Phone:-(772)-462=1553—Fax:-(772)462-4578 Commercial Residential x
PERMIT TYPE: HVAC-Mechanical
PROPOSED IMPROVEMENT LOCATION
Address: 2224 N 53rd St. Fort Pierce, FL 34946
PropertyTax ID #: 1431-701-0228-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Install 2-ton 16-SEER 5-KW Goodman AC with new ductwork.
CONSTRUCTION INFORMATION;
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 4-)VO Utilities: —Sewer _Septic
—Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name L L C.
Name: Edgar Gregory
Address:
Company: First Air Airconditioning
City: a)ak-' State I
Zip Code: Fax:
Phone No.
Address:17624 127th Dr N
City: Jupiter State: FL
Zip Code:33478 Fax:
Phone No 561-793-6282
E-Mail:
Fill in fee simple Title Holderon next page ( if different
from the Owner listed above)
E-Mail FlrstAirAC@Gmail.com
State or County License CAC-042616
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRU N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICF/bF COMMENCEMENT."
2
Signs re of Owner/ Lesse ZContactor as Agent for Owner
Sigfiature of CerntractoC/LicOnse Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SSr_ \-., R,s
COUNTY OF PW.13 oh
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thiiss�j-7- day of C)Cb c_E2 .2W�by
this 24 day of serptember 20 /9 by
Edgar Gregory
Name of person making statement.
Name of person making statement.
Personally Known � OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
C
O
(Signature of No Pub c--tg o dlicSfate of Florda
NOTARY PU9LtC
Si ature Notary Public -State of*..
Commission No. z2 2eotea
Commission No. CFFLORID
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