HomeMy WebLinkAboutBuildiing permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
------------- - Building Permit Application
I
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Commercial Residential—k—
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:HVAC Equipment ChangeOut
Address:
'-1 A / /
Property Tax ID #: ��v� V i 'ya l 5" 000 — "f Lot No.
Block No.
Site Plan Name:
Name:
Project
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Like for like AC replacement
CONSTRUCTION INFORMATION: _ ____ ._. --------
Additional 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: \_ C7 Sq. Ft. of First Floor:
Cost of Construction: $ 34? Utilities: —Sewer —Septic Building Height:
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Name {�ifsrl3
Name: Steve Smith
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Company: Steve Smith Air Conditioning
Address:
`-1(401
City: �oYl�L2� State: A=
Address:8001 Eden Road
City: Fort Pierce State: FL
Zip Code: 7.4ASI Fax:_
Phone No."� a _ ) —
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Zip Code: 34961 Fax: 772-461-2036
Phone No772-461-1425
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail stevesmithac@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:
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 T E JOB_ M BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y LENDF, ,6111 AN ATTORNEY BEFORE RECORDING YOUR NOTICE COMMENCEMENT."
Signature of Owner,
as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORID
COUNTY OF 5�- -LLU C.N F COUNTY OF � 'LVt'- I -P
The forgoing instrument was acknowledged before me 20j � by I The forging instrument was acknowledged before me
this Jq�yday of
� u this _�l day of 20_t5 by
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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 Type of Identification
Produced DRA VuL L I C- 6-1 S EE Produced
ignat a of ota Public- S to of Florid ChristopherJ. nature Notary Public- State o Flo { Stephanie Mo
NOTARY PU LIC �? NOTARY PUE
Commission No. 22�-1 STATE OF 013M gission No. FFg:i 7A a STATE OF F1
Comm# GG 2758 . ; �= Comm# FF95
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
COMPLETED
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