HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE I FO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
�� f 7� 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:
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
I I.o fnr li4o �(` rcnlar`amant
Lot No. Z u
Block No.
CONSTRUCTION INFORMATION;
AdditioI work to be performed under this permit– check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing> _ Sprinklers _ Generator
Total Sq. Ft of Construction: /G �G _ Sq. Ft. of First Floor: _
Cost of Construction: $ 1�)evc" Utilities: —Sewer _ Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 4 ��' /�/C,^, `
Name: Steve Smith
Address: % XI
Z� �� �'���' , t'f'
City: / O"� r�C-��c'ii State: �,
�'
Zip Code: 7/i �/� Fax:
Phone No. i %2? y7
E -Mail:
Company: Steve Smith Air Conditioning
Address: 8001 Eden Road
Cit Fort Pierce State: FL
Y
Zip Code: 34951 Fax: 772-461-2036
Phone No772-461-1425
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailstevesmithac@aol.com
State or County License CAC1 813454
If value of construction is $2500 or more, a KLGUKULU Novice OT Lornmencemem lb rcyuu cu.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State
Zip: Phone
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:,
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:_
_ Not Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao the worK anu insL411auu11 d-1
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. Please consulth t nwithpyoiurr Hlome Owners Association e Owners iandrreviewbylaws
y ur deed for any restrictions nts that 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 ONT E JOB BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
N ATTORNEY BEFORE RECORDING YOUR NOTICE -Of COMMENCEMENT."
WITH Y LEND R A
L
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID
•LVC.'
COUNTY OF Sir. LU t,N F
COUNTY OF
The forgoing instrument was acknowledged before me
The forgging instrument was acknowledged before me
this Lyday of tA &4-1, %A 20_a by
this jl!day of 20_x-' by
SfPit'✓1 S+'� ��""
�i&VC0 SM %-r 14
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification �_
Personally Known OR Produced Identification k
Type of Identification
D(Lt VEIL �- I C- E''' S E
Type of Identificationu
Produced L-
Produced
a of ota Public- S to of Florid Christopher J.
WE
r nature f Notary Public- State o Flo { Stephanie Mour
NOTARY PU
LIC �? o� NOTARY PUBLI
Commission No. 22�-STATE OF
@6ila51Raission No. ��G%'r7-F '.4 STATE FLO
Comm# GG
2758 +; = Comm# FF9573
0
10
-�piras 914190
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
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