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HomeMy WebLinkAboutBuilding permit appAll APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 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 #: /�d�f�� ����� — ��©✓ Site Plan Name: Project Name: Lot No. Block No.2 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: %/f� Sq. Ft. of First Floor: Cost of Construction: $ J Utilities: —Sewer _Septic Building Height: IN 1116, �� art( • . .. ..... : '. ,..... a .� .. .. Name: Steve Smith Name <<`�'r% �= Company: Steve Smith Air Conditioning Address: /%r/ �u% City: /c �1��f State: c'- Address:8001 Eden Road Zip Code: �%1��� Fax: City: Fort Pierce State: FL 77z �//G� Zip Code: 34951 Fax: 772-461-2036 Phone No. Phone No772-461-1425 E-Mail: E-Mail stevesmithac@aol.com Fill in fee simple Title Holder on next page (if different from the Owner listed above) State or County License CAC1813454 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. a 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 r�ucture. conflict lease consult withpyourHome ownOwners rs Associa ion andrreview your deed fora nyrestrictions 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�SII�E BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH Y LENDS. %R qN ATTORNti BEFORE RECvRDI DING YOUR NOTI � COMMENCEMENT." .e:­1 v Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA[ Lvc I COUNTY OF S-c l_u L\ F COUNTY OF - The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 1g7yday of t,A a�� 20� by this � day of (� 20� 1 by <,e-L&vCp SM i-r4 NName of person making statement. Name of person making statement. k Personally Known OR Produced Identification _)C Personal) , Y Known OR Produced Identification Type of Identification Type of identification Produced _12— VE(t- L I C. E-N S E Produced C— Stephanie MC ignat a of ota Public- S to of Florid y Commission No. 2221 •� �(a11 nature Notary Public- State o Flo { ChristopherJ. NOTARY PUI NOTARY PU LIC STATE OF 01300 aission No. R-- 9Y 7A l a STATE OF FI Comrn# GG 2758 ? Comm# FF95 0i.•s REVIEWS CFRONT OUNTER RONING EVIEW SUPERVISOR REVIEW PLANS RE EW VEGETATION EVIEWS REVIEW LE MANGROVE VII DATE RECEIVED COMPLETED ev. Z77 .�2W"?