HomeMy WebLinkAboutWalstonPermitSLCAll APPLICABLE INFO ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /� Permit Number:
RtiµA 9 l a t^.1A \
J 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
PERMIT TYPE:HVAC Equipment ChangeOut
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: ��r�/� ' Lot No.
Site Plan Name: Block No. �.
Project Name: —_
DETAILED DESCRIPTION OF WORK:
Like for like AC replacement
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
�fvlechanical _Gas Tank _ Gas Piping — Shutters — Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: %f S K) Sq. Ft. of First Floor:
Cost of Construction: $ `% �' (� Utilities: _ Sewer _ Septic Building Height:
-- -- ----
OWNER/LESSEE:
CONTRACTOR:
Name: Steve Smith
, �,
Name L %r "
Address �fi �/ � v/C' ti
p State: �r
City: �� /"/i''/l/
Zip Code: � y i Fax:
Phone No.
Smith Air Conditioning
Company: it
Address:8001 Eden Road
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-461-2036
Phone No772-461-1425
:
fee simple Title Holder on next page ( if different
he Owner listed above)
L
E-Mailstevesmithac@aol.com
State or Count LicenseCAC1813454
y
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.
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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:
_ — �L_ ...-A,
--A oc indirntaCi.
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to ooialn d FtCI IIII1 LU uU LlI_ VVW•„ - -- --- -
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 structure. Plconflict
asie consult with yolur Home Owners Association landrreviewyyour deed or any restrictions which may applyhibit 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 I IE JO&SM BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
1/■srrnonlur" vnl ID NnT1rF cm rn MMENCEMENT."
WITH Y LEIYU K n A l 1 UKI IC l or-rvffc&--
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID
Lor e
COUNTY OF S-r- (LU t�% F
COUNTY OF
The forgoing instrument was acknowledged before me
The foraging instrument was acknowledged before me
day of �1(c�._ 204 by
this L`Iday of �� r►s• �.0 20j by
this .
<--(&V6N SM t'r4
S/C'Vt'✓1 S►�r
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification k'
Type of Identification
L I C- 6--, S E
Type of Identification
Produced L—
Produced Da_VtAl
ignat a of ota Public- State of Florid ChristopherJ.
r nature If Notary Public- State of Flo { Stephanie Mour
t ¢, NOTARY PUBLI
NOTARY PU
Commission No. 2221 —6 STATE OF
LIC
@61�flaission No. �F 9Y 7 / a a STATE OF FLO
Comm GG
2758 �; = Comm# FF9573
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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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