HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INPO MUST E COMPLETED FOR APPLICATION TO BE ACCEPTED
zlz� Permit Number:
Date:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Commercial Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:HVAC Equipment ChangeOut
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A(dress:
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Property Tax ID #: ���/� "� S�f �- /
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Site Plan Name: Block No.
Project Name:
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Like forklike AC replacement
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Additio I 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: I���' Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
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2:01, Will
Name:Steve Smith
Name i� " �!
Address:
Company: Steve Smith Air Conditioning
Address:8001 Eden Road
City: State: fZ
Zip Code: f6z Fax:
City: Fort Pierce State, FL
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Phone No.-7 7,? - 24�' - ��3'2
Zip Code: 34951 Fax: 772-461-2036
E-Mail:
Phone N0772-461-1425
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 CAC1813454
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of ll 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:
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 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 SM BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YONFILENDEW R AN ATTORNEY BEFORE RECORDING YOUR NOTICE,Of COMMENCEMENT."
Signature of Owner
as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA STATE OFFLORID r
COUNTY OF fLU C.N F COUNTY OF ID
COUNTY
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1q�yday of 204 by this Jinday of "jL 20_L51 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 17R-\ VET L E"' S E Produced
r
ignat a of ota Public- S to of Florid ChristopherJ. � nature Notary Public- State of Flo { Stephanie I
NOTARY PU LIC * NOTARY F
Commission No. Z2�-1 �€j STATE OF @131PA4ission No. �F9Y 7Ae a a STATE OF
Comm# GG 2758 w, ? Comm# FF
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED