HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA
BE COMPLETED FOR APPLICATIM TO BE ACCEPTED
?ermit Number:
Building Permit ApplicAtion
Planning and Deieic,rrrent Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: HVAC Equipment Change®ut
Address: / /611s f 7 `
Property Tax ID #: �' Lot No.--Z,�—
Block No. 6_
Site Plan Name:
Project Name:
Like for like AC replacement
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AddVoal work to be performed under this permit- check all that apply:
echanical _ Gas Tank _ Gas Piping `Shutters
_ Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction: /�i��1� Sq. Ft. of First Floor:
Cost of Construction: $ G� �� Utilities: _ Sewer _Septic
N a m e 9K-7 %'h 0/GEC/-r
Address: 710f l" 9 �' `7
City: /e�� i��l� State: %-z
Zip Code: 7V1�l Fax: /
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
441 i
— Windows/Doors
Roof Pitch
Building Height:
Name: Steve Smith
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.
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
str ctis ure. Please consult withpyo'ur applicable
ome Owners Association land reviewyyour deed or any restrictions which may applyhibit 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lends- or apottgrOy before commencing work or recording your Notice of Commencement. _
Signature of Owner/ Lessee/Contractor as Agent for Owner
V%t..AA
STATE OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
this -day o `t , 20'1 by
Y
rV�
Name of person making sta ement.
Physical Presence or Online Notarization
Person Known OR Produced Identification ��•`�PQAWN ,',,
Type of I ntification Produced f-'l I DL S'S3� 7'b1550� ate: `���. �O
NOTARY L�
PUBLIC U
ture of Notary Pu
No.11 V 11 7-I—
Florida )
(Seal)
REVIEWS I FRONT I ZONING
COUNTER REVIEW
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