HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE I FO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date- 2J Permit Number:
-- ---- -- -� Building Permit Application
Planning and Development Services
Building and Code Regulation Division /
2300 Virginia Avenue, Fort Pierce FL 34982 V/
Commercial Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: HVAC Equipment ChangeOut
::.
Address:.
���2 '� ���✓ 3 Lot No.
Property Tax ID #:
Block No.
Site Plan Name:
Project Name:
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Like for like AC replacement
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Add7itioal work to be performed under this permit — check all that apply:
Windows/Doors
echanical _ Gas Tank _ Gas Piping _ Shutters _
_ Electric _ Plumbing _ Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: )>z Sq. Ft. of First Floor:
IG
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
7 5
Name G �s �/ Name: Steve Smith
r
Address: ���� /�� �'//� (' ✓ Company:Steve Smith Air Conditioning
City: �r✓lf' State:1 < Address:8001 Eden Road
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Zip Code: 7%157 Fax: City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-461-2036
Phone No.
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 LicenseCAC1813454
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
which is
conflict
leasle consult withpyour Home Owners Assoc ation'and reviebylaws
yo r deed and covenants
restrict that
wh restrict
may alprohibit such
strIn 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 lendpr or a tt before commencin work or recordin our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
V %CcSg1�� '�— �
STATE OF FEARID 1 `
COUNTY OF 0 re
Sworn to (or affirmed) and subscribed before me of —\--*Ysical Presence or Online Notarization
this 20-.4 by
MAY
Name of person making sta ement.
10%%%% of,'�.
Person Known OR Produced Identification ��� PDAWN
Type of I ntification Produced i—L DL S'S3� 7t�1550� ao:: NOT
ARY ' 'L
PUBLIC �
of Notary Public1kf Florida )
o mission No.'7'1 V 1'1 7-l.. (Seal)
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
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