HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l' 7U Permit Number:
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
PERMITTYPE:HVAC Equipment ChangeOut
Address: s`7 SI
Property Tax ID #:
Site Plan Name:
Project Name:
Like for like AC replacement
Lot No.
Block No.
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al work to be performed under this permit — check all that apply:
anical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:. 1%Tz7
Cost of Construction: $ ), /GW
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
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Name 4
Name: Steve Smith
Company: Steve Smith Air Conditioning
Address: 7? 111 �i i/ %o< zkly%
City: State: /11
Address:8001 Eden Road
City: Fort Pierce State: FL
Zip Code: /dr/7� Fax:
Phone No. �/7 -- S-7-T—
Zip Code: 34951 Fax: 772-461-2036
Phone No772-461-1425
E-Mail stevesmithac@aol.com
E-Mail:
Fill in fee simple Title Holder on next page ( if different
State or County LicenseCAC1813454
from the Owner listed above)
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.
t�M T
MORTGAGE COMPANY: _ Not Applicable
DESIGNER/ENGINEER: 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:
City:
Address:
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 PE JOB ,SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUWLENDE,W R AN ATTORNEY BEFORE RECORDING YOUR NOTICEff COMMENCEMENT."
Signature of Owner
as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF S—r. LLU r—N F COUNTY OF S f LUr ^e
The forgoing instrument was acknowledged before me The forgging instrument was acknowledged before me
this Lyday of � _t,u 20JA by this � day of _t!11(�_ 20_Lg 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 Type of Identification
Produced D(L1 VtAR L I E''' s E Produced rL_ u L—
ignat a of C ota Public- S to of Floriddt Christopher,!. � nature f Notary Public- State o Flo ' Stephanie I
2221 S_G NOTARY PU LIC 5e 9 J 7 A / o� STATE OF
NOTARYF
Commission No. p STATE OF @6i�flgission No.
Comm# GG 2758 �; Comm# FF
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
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