HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -- Z --- Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division f /
2300virginiaAvenue, Fort Pierce FL34982 Residential v
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: HVAC Equipment ChangeOut
Address: �ti�i 'v
�Lot No.
Property Tax ID #: / �'2s2
Block No.
Site Plan Name:
n..t + KIMM0.
Like for like AC replacement
,ee J� �%
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: 9117/f::�: Sq. Ft. of First Floor:
Cost of Construction: $ 7r�� Utilities: _Sewer _Septic Building Height:
. .r.:b7ce• ..
I Name. Steve Smith
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p
City: /c� State: z .�'�/rt
Zip Code: 3%rl'-1 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
r'^r„r,ar,,.Steve Smith Air Conditioning
Address:8001 Eden Road
City: Fort Pierce State: FL
Zip Code: 34961 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:
— 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:
_ �_ ,. L.— ,..-.I. -..,.4 nc inrlifatpri.
OWNER/ CONTRACTOR AFFIDVIT: Application is nerecy mace to ootanl a NCF InL LU UU �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
Please consult any
thpyolurHle Home ome OwnOwners ers Association landrreviewylaws or anyour deed for any covenrestrictions which may aestrict 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 1E JOB_AffE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
vniira NnTIrP em rnMMENCEMENT."
WITH T LtIYU K n AN aVKnL�..�..vw
— -- — ---
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORID
Lv
COUNTY OF S-c L u c.N F
COUNTY OF
The forgoing instrument was acknowledged before me
The foying instrument was acknowledged before me
this _JgTyday of " &z•A 204 by
this � day of M Iq 20_t5 by
S kL e-,1 S►%c 1
�1<& V C0 S M % -T 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
DR1VC-A. �-I �E+�SE
Type of Identification
Produced L—
Produced
ignat a of ota Public--Sfate of Florid ChristopherJ.
r nature Notary Public State o Flo ' Stephanie Mour
�' NOTARY PUBLI
NOTARY PU
Commission No. 2221��j e STATE OF
LIC
@RiaRaission No. �Fg6r7 l a STATE OF FLO
Comm# GG
2758 .r a Comm# FF9573
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Rev.
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