HomeMy WebLinkAboutAC CHANGE OUT LIKE FOR LIKE 7646 EASTERN BLUEBIRD DRAll APPLICA I E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 Al 9-0d"I Permit Number:
° " - `'' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Property Tax ID #: 2, LI aN —quo' 0 IOb — °zo-0 Lot No. 3to
Site Plan Name: - O
r Block No.
Project Name: W OL'4(i � S)
I DETAILED DESCRIPTION OF WORK: I
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit- check all that apply:
'Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Pond
_ Electric _ Plumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ y �y--* 1 00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name c7mC4
Name:
Address: +'P c4 fc C C�5;' vl �11 +c �i' ✓d -01-.
Company: 3 l r �� �[ . ci
p
b p
City: PsL_ State:Ft--
Zip Code: 3 XIrl Sa Fax:
Phone No.
Address: lo V 1 Ve,
City: Mx- State: FL
Zip Code: 39°1S11-D, Fax: 13a-Yc.I-I(-31
Phone No - yeI f � I 1
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail niti 4) rLA , (oe�
State or County License CACD.S 3'3-8'
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Appricable
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: a .
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 j4ssociation rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Asspciation 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 BL[ilding 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 is 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 lender or an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for'Owwer
STATE OF FLORIDA
COUNTY OF <x - WL;% e—
Sworo (or affirmed) and §ubscribed before me of: se" Physical Presence or Online Notarization
this 27daY of J , 20ak, by
A
;i
Name or person making statement.
f
Personally Known OR Produced Identification
T f Identification Produced
nature of Notary Public- State of Florida }
Commission No. i 0(0 I a+ ��+�,
_. (Seal) - ,,Z,�.,JESSICA GROVER
z�,4 °�,� Notary Public -State of Florida
•= Commission # HH 119064
My Commission Expires
April 19, 2025
REVIEWS FRONT ZONING SUPERVISOR PLANS I VEGETATION SEA TURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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MP102989
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:DESCRIPTION OF WORK
SERVICE 9S 558 !
CALL#
SCHEDULED
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• #2 IN OUT
PAYMENT
I haveTeeeived and agree to the terms and conditions of my contract, and I understand
6i that Ehla service is a claim against my contract.
10k PARTts WARRANTY
0 All earl's as recorded are nled as per manufacturer specifications.
-; LABOR GUARANTY
The labor charge as recorded here
relative to the equipment serviced as noted, Is guaranteed for a period of 30 days.
We do not, of course, guaranty other parts than those we Install. If repairs later become
necessary due to other detective parts, they will be charged separately.
No guaranty on any drain stoppages.
BFS WILL NOT BE RESPONSIBLE FOR PROPERTY DAMAGE WHEN
REMOVING
TO PERFORM NECESSARY SERVICE WORK AND I ACCEPT
PERFORMED ERVICEUIRRGESAS BEING SATISFACTORY
All Sales are a with nor refund.X__—.__
R.'Slr;MEHSI:NATI��c—
PARTS
LABOR
SERVICE
CHARGE-
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❑ PARTS ORDER
❑ NOT HOME
❑ RESCHEDULE
O OTHER
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