HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Sl ,a� `p Permit Number:
F RECEIVED MAY 1 2016
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
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMP ROVEME,NI TCATION.
Address: 1844 Walden Pond Dr.
Legal Description:
Property Tax ID#: I") -�) ' Cbz_ ^O[ 7 -'� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF,WORK
r.
Changeout of a 3 ton packaged unit with 10 kW electric heat."like for like"
CONSTRUCTION INFORMATION ;
Additional work toe e orme under this permit—check a appy:
HVAC F]Gas Tank ❑Gas Piping 1:1_Shutters Q Windows/Doors
11 Electric 1:1 Plumbing Sprinklers 1.1 Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3600 Utilities:Sewer Eheptic Building Height:
OWN ER/LESSEE CONTRACTOR:
Name Viy i(Ari S I ornraki Name: James J Wauters
Address: 'J%144 Wad n Pri)arl 'DC- Company: Just Chillin' HVAC LLC
City: T rJ4 Pt e+me, State:FL. Address: 5422 NW Cromey St
Zip Code: ?H 91AS Fax: City: Port St. Lucie State:FL
Phone No. -117-aft dal Zip Code: 34986 Fax:
E-Mail: Phone No. 772-940-4373
Fill in fee simple Title Holder on next page(if different E-Mail: justchillinair@hotmail.com
from the Owner listed above) State or County License: 26326
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN"L-AW.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:
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 thepermit 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
lJ Q- di Ak� i nn- d LTJ /,/-"
Si ature of ner/Agent/Lessee Si ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SJr. Ii—ycCOUNTYOF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of M 0.N_ 20 NS:by this\IE�,day of Mo,! ,20. by
4M i-�
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florid �,i�ENs a (Signature of Notary blic-State of Florida)
pEPNNP Sate°1;6 20 6 , y9 tfN7�� lrida
Personally Known OR ro uced I� ific�tigx�° Personally Known ._CIGW�`Ro cecl Ideo,�jra6Type of IdentificationgPt�b �c3 BY ° YL'.E p�� EE a'O ssn• Type of Identification Prbduc ' ,.'ti- '
�b �y comms h�1atJonai�,� � fi a =MY R�ission� Assn.
Commission No. ":F`"u alp° , "� Commission No. X51_'_ " °�; S ' ��ghNaUOna}No1a'y
Revised 07/15/2014
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