HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MU T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1,6 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Commercial Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE HVAC Equipment ChangeOut
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Address: % f_e � _
Property Tax ID #:^�1 �i OZ — ` Lot No.T_
Block No.
Site Plan Name:
Project Name:
Like for like AC replacement
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Additio al 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: Sq. Ft. of First Floor:
Cost of Construction: $ ���0 Utilities: —Sewer —Septic Building Height:
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Name: Steve Smith
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Company: Steve Smith Air Conditioning
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City: State: �G
Address:8001 Eden Road
City: Fort Pierce State: FL
Zip Code: Fax:
Phone No. 7727 — e111— 77573'
Zip Code. 34951 Fax: 772-461-2036
E -Mail:
Phone No772-461-1425
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.
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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 E JOB BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y LEND R N ATTORNEY BEFORE RECORDING YOUR NOTICE.01F COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID
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COUNTY OF S—s LU C-N F
COUNTY OF s r
The forgoing instrument was acknowledged before me
The forgging instrument was acknowledged before me
M 20_Lj by
this Lyday of 204 by
this JInday of (c
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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\ L 1 c- E'"' S E
Type of Identification
Produced %fL- u t—
Produced Vt4L
ignat ta a of oPublic- S rte{ to of Florid Christopher J. nature U Notary Public- State of Flo ' Stephanie Mour
NOTARY PU 3LIC NOTARY PUBLIC
Commission No. STATE OFF 4130%ission No. F)–'93'?-1 l a STATE OFFLO I
Corrin* GG 2758 �; =Comm# FF9573 1
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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