HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE I IFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
PERMITTYPE:HVAC Equipment ChangeOut
PROPOSED IMPROVE MEINT LOCATION:
Address:
Property Tax ID #: U 2 " 6'1f 7 0(2 _ 7 Lot No. d
Ci+o C11— Almmc• Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
I:1. A/'
CONSTRUCTION 1'NFORMATION;
Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:C J 9 Sq. Ft. of First Floor:
Cost of Construction: $ >� ��� Utilities: _ Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ���� L/ f, cgr
Address:%�� �f`i/,%�q ���s' i/j
City: State: 2t=
Zip Code: �l G _ Fax:
Phone No. gS�%' y%�/ ` 7�%%
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Steve Smith
Company:Steve Smith Air Conditioning
Address:8001 Eden Road
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-461-2036
Phone No772-461-1425
E-Mail stevesmithac@aol.com
State or County License CAC1813454
If value of construction is $2500 or more, a KtcVKutu Nouce OT commencement 15 requlreu.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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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
Home Owners tiandrreview bylaws covenantsthat or such
which may atrict
pply.
sult with pyoiurHle
ur deed for any
stlructure. Pleain secconwith
ome Owners Association
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 T E JOB BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y LEND R ATTORNEY BEFORE RECORDING YOUR NOTIC COMMENCEMENT:"
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID
,
COUNTY OF S-t LU LN F
COUNTY OF .S, •LUC
The forgoing instrument was acknowledged before me
The forging instrument was acknowledged before me
� day of AA (,q 20_L-� by
this L`Iday of M A,"%A , 204 by
this
';M ►T14
St���✓, S+k I
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification �_
Personally Known OR Produced Identification k
Type of Identification
17R-1 t_ I C_ &., S E
Type of Identification
Produced
Produced tA,
NOTARY PIC
ignat a of ota Public- S to of Florid Christopher JJ2758
Stephanie Mour
PUBLI
� nature f Notary Public- State o FlV.-r-
22j
Jc�NOTARY
No. R— 9Y7-1 l aSTATE OF FLO
I
Commission No. STATE OF80%ission
91
Comm# GG
Comm# FF9573
1
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
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