HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE I FO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� �� Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential
PERMITTYPE:HVAC Equipment ChangeOut
PROPOSED IMPROVEMENT LOCATION:
Address: />1
Property Tax ID #: �� /� "' �� ��� �f J73�
Site Plan Name:
Project Name:
Lot No. 57/
Block No. / f
DETAILED DESCRIPTION OF WORK:
Like for like AC replacement
nAll 7- 612
CONSTRUCTION INFORMATION.
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: r� 'Z'/% Sq. Ft. of First Floor:
Cost of Construction: $ 3-rt--� Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Z � �t�/ai Ulna
Name: Steve Smith
Address: �ii�p� ���� UT�
Company: Steve Smith Air Conditioning
Address:8001 Eden Road
City: Stater
Zip Code: Fax:
Phone No. G��`/- 26— �7/s
City: Fort Pierce State: FL
Zip Code:34951 Fax:772-461-2036
Phone No772-461-1425
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail stevesmithac@aol.com
State or County LicenseCAC1813454
If value of construction is 52500 or more, a RECORDED Notice of Commencement is requires.
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
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 AE JOB,9M BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITU Ynue�i FiunF.r#AP AN eTTnRNEY gEEORE RE[ORDINC YOUR NOTICE -OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID 11�
LU
COUNTY OF S-r LLU C.N F
COUNTY OF T _ i
The forgoing instrument was acknowledged before me
The forgging instrument was acknowledged before me
this _Jq� day of "& g 204 by
thisday of M 20_tj by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification �_
Personally Known OR Produced Identification k
Type of Identification
DR1 L 1 c- &"'+ S E
Type of Identification
ProducedL—
Produced VL_,L
r
Chr topherJ.
ignat ta a of oPublic- -State of Flo*X.M%
rxagl nature f Notary Public- State o Flo { Stephanie Moure
NOTARY PU
Commission No. 2221�€j STATE OF
LIC NOTARY PUBLIi
@6i1PAission No. FF9Y7_5�c� a a STATE OFFLOF
CommGG
2758 �+?Comm# FF9573E
1�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19