HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUS5j BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /� s/ 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 ___jZ—/ Residential
PERMIT TYPE: HVAC Equipment ChangeOut
Address:%�� T�*✓r�/�i�1/ / �1���// /<G/
Property Tax ID #:
Site Plan Name:
Project Name:
Lot No.
Block No. 171
Add itio al work to be performed under this permit— check all that apply:
7Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name
Address: , '
City: r/ State: �'1
Zip Code: Fax:
Fax:
Phone No.
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.corn
State or County License CAC1 813454
If value of construction is $2500 or more, a RECORDED Notice of Lommencemeni is requireu.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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Not Applicable
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: —
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
BONDING COMPANY: Not Applicable
FEE SIMPLE TITLE HOLDER: _ 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
structure. ture. with
any
with applicable
lome Owners Owners
ssociation iandrreview your deed for abylaws or an covenants
y restr restrictions which may atrict or . prohibit 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 T E JOB BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y LENDI WffiR ANE ATTORNEY BEFORE RECORDING YOUR NOTICNM COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORID r
COUNTY OF_ (LU t.\ F COUNTY OF Lug ^ -
The forgoing instrument was acknowledged before me The for�ing instrument was acknowledged before me
this Lyday of wJla �u 201a by this � day of n'1(.L20_Ll� by
` ,- E V CP S &A 1-C 4 S I ex✓1
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 D(R1 VER. L I C E j S E Produced L—
ignat a of ota Public- St
to of Florid ChristopherJ. r)fff nature Notary Public- State o Fl*Stephanie I
NOTARYPU LICx�NOTARY P
Commission No. 2221�s STATE OF @619Raission No.5-932A l aSTATE OF
Comrrr# GG2758Comm#FF
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
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