HomeMy WebLinkAboutBuilding PermitAll APPLICABLE I FO ST 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 349S2 Residential ,V/
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: HVAC Equipment ChangeOut
Address:
Property Tax ID #:
Site Plan Name: _
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2
Additional 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: Sq. Ft. of First Floor: _
-
Cost of Construction: $��� Utilities: —Sewer _Septic
Name
Address: «"
City: State:
Zip Code: )l/Sf�/, Fax:
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Phone No_
E-Mail:
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
Name- Steve Smith
Lot No. / jr-
Block No. SZ
Windows/Doors
Roof Pitch
Building Height:
Company: Steve Smith Air Conditioning
Address:8001 Eden Road
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-461-2036
Phone No772-461-1425
E-Mail stevesmithac@aol.com
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:
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_
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 T E JOB OTE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOWLEND R AN ATTORNEY BEFORE RECORDING YOUR NOTICE.OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Ho
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S-r L_U C.N F COUNTY OF , LUC_ Le
The forgoing instrument was acknowledged before me I The forgging instrument was acknowledged before me
this_L Tydayof tAa,"A 204 by this JIN"day of C[,4_ 20,Jjby
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(2-VE.;R. �- 4 C- E"' S. E Produced �'� Q L—
ignat a of 11�2 Public---S-tate of FlorgChdstopheri. rW nature Notary Public- State o Flo ' Stephanie I
SGNOTARY PU LIC � ¢, NOTARY F
Commission No. 2Z21S6STATE OF 013MAission No. FF9Y 7A / a STATE OF
Comm# GG2R2758 ,+ ? Comm# FF
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
COMPLETED
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