HomeMy WebLinkAboutBuilding Permit Application . x
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:APPLICABLE NF MUST BE tOMOLET,ED FOR APPLICATION TO BE ACCEPTEDnn
hermit Number
Bug.ding�Perrnit Application _
Planning:and Deeveloprnent`Servjces`
Balldlrtg'and:Fade Regula[lon Drvsror�::
Phone mra Avenues Fort
'FL34982-
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23001�rg
-2f445
6253 Fax.,(3r72)462 157y :.COt1lIYtGYCial ReSIt11tIaJ
. .PERMIT TYPE.
HVAC Equipment ChangeDut
Address:- ? �/ ° ur
Property i.ot No
Blo,'.ck No ., C
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.Like foxlike AG replacement
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Additional WWO-, be perf6rrc►ed under thisi;permit=check ati:#hat apply::
echanical _Gas Tank' _Gas Piping Shutters 1tVmdowsjDoors
_"E(ectric Plumbing _Sprinkle*st Geherator Roof Pitch
Total Sq Ft ofYContruction r Sq Ft.of First Floor;
Cost of Construction:$ �� Utilities;.-_Sewer: Building Heighf;-
Se tic,lmea ` .% n �~ Nameteve ddress. �/dl 4� / - z4��, Company Steve smith A�r'Condion�ng
State �G' Address 8001 Eden Road.
Ztp Code T��rl fax City:. Fork Fierce .` statFL �^
°phone=No Zip Code 3495. Fax 7*40172436
E Mail: ` Phone No772-461 1425 _
Fillin fee simple Title Holder on;next page;{if different'. E IVlai)
stevesmithac aol coin
frocn:the Ownet listed abave�,. State or County Licensel. 3454`
81'
If value of,construction,is$2500:6r more,a RECQRDED Notice.of Commencement is required
If value of HVAC>is$7:,500 or more,a:RECORDED Notice:of Commencement is.requ��ed.
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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
struc ure. conflict
lease consult with pyoiur Hlome Owners Association
iandrreviebylaws ur deed for covenants
which may aor pply. obit such
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�E JOB BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YQUW LENDF,({I R AN ATTORNEY BEFORE RECORDING YOUR NOTIC f M COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORID
COUNTY OF S—r U e— F COUNTY OF 1,LUC ,p
The forgoing instrument was acknowledged before me I The forgoing instrument was acknowledged before me
Ly this day of M&A t A , 204 by this J�nclay of �{(� 20J' by
�r&V6N SM t'C4 S�Pi1t'✓1 S►''� !�
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification k
Type of Identification Type of Identification
Produced l7(L1 VE& �' I E a� S E- Produced t`` u L—
ignat a of fi,2La Public- S to of Flo&C=m#GG',
CnAstopherJ. r nature I f Notary Public State
NOTARY PU LIC
Commission No. 2 :Ll5- jSTATE OF @i M0%ission No. �F9� 7 �' /
2758
NOTARY P
STATE OF
Comm# FF
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED