HomeMy WebLinkAboutBuilding Permit Applicaiton 06/21/2019 12:55PM 7724612036 Steve Smith A/C PAGE 02/03
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All APPLICABLE INFO MUST IRE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: b �� / Permit Number:
REC51VED
JUN 2 . 2016
Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division. St. t Ocie county
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)452-1553 Fax:(772)462-x,.578 Commercial _ Residential
PERMITTYPE:HVAC Equipment ChangeOut
v 1 r ( I
Address:
Property Tax ID#: ! Qin r ' Lot No. _
Site Plan Name: Block No. 5'
Project Name:
Lik®for like AC replacement / r
Additional work to be performed under this permit—check all that apply:
_Mechanical �GasTank _Gas Piping _Shutters Windows/Doors
Electric _Plumbing _Sprinklers Generator _Roof Pitch
Total Sq.Ft of Construction: /I Sq. Ft.of First Floor:
Cost of Construction:$ S,✓✓ _ Utilities- _Sewer _Septic Building Height:
s' a
4
Name ✓d��r' zK Name:Steve Smith
Address: /Cj ��d��o� Company,-Steve Smith Air Conditioning
� 8001 Eden Road
City: �� /��'�li State:`� Address: _
Zip Code: .s7t'j/l/ Fax: City: Fork Pierce State:FL
34951 77�-461-2036
Phone No_w�� r 6�' -' ��� Zip Code: Fax:
E-Mail: Phone N0772-4611425
Fill;in fee simple Title Holder on next page(if different E-Mailstevesmithac@aol.com
from the Owner listed above) State or County License CAC1 813454
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.
06/21/2019 12:55PM 7724612036 Steve Smith A/C PAGE 03/03
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name Name:
Address: Address:
City: State: City: state:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: 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.Lucle 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 Nome 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 15AILURIE TO RJECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE MR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED'AND
POSTED ON TUIE JO8,01TE BEFORE THE FIRST INSPECTION. W YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y LEND R IV ATTORNEY BEFORE RECORDING YOUR .OTIC COMMENCEMENT."
Signature of owner/Lessee/Contractor as Agent for owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
j �
COUNTY OF_ �--T i'_ u G 1 I� COUNTY OF ��"•LL),r r
The forgoing instrument was acknowledged before me The for ing instrument was acknowledged before me
this Lyday of h4 4g-" _,24� by this.'r day of (i4 f" 24 b
� � y
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification, Personally Known OR Produced Identification
Type of Identification �I Type of Identification i
Produced (Lt VEL S t= Produced 11
ign?. a of"Public- to of Florid Chfttopher1 r3 nature Notary Public-State o Flo ' Stephanie';Mour
"?"Z Z-� GG NOTARY PU LIC NOTARY PUBL1
Commission Na,q�r
C� STATE OF OWAission No,F1�7 96 -� / 8 STATE~OF FLOI 01
Comrrf#Gd2122758 Comm#F�9578 I
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j REVIEWS FRONT ZONING SUPERVISOR PLANS . VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED I
DATE
COMPLETED
Ev.
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