HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:HVAC Equipment ChangeOut
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Address: oe r //- 12 17
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
.2.'=--�'7 ........... .....................
Like for like AC replacement
A41 7�1 14�1
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Additio a[ work to be performed under this permit- check all that apply:
/Mechanical Windows/Doors
Gas Tank Gas Piping — Shutters
Electric Plumbing Sprinklers — Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ '��p Utilities: —Sewer _Septic Building Height:
Name zry
Name: Steve Smith
Company: Steve Smith Air Conditioning
Address:
City: ZS-e-1 State: AZ
Address:8001 Eden Road
Zip Code: 7ffsl/- Fax:
City: Fort Pierce State, FL
Phone No.-re7
Zip Code: 34951 Fax: 772-461-2036
E-Mail:
Phone N0772-461-1425
Fill in fee simple Title Holder on next page if different
E-Mail stevesmithac@aol.com
I State or County License CAC1 813454
from the Owner listed above)
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.
L—
DESIGN
— Not Ap
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
rite
Zip: Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as inoicateo.
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
structure. conflict with
withpyolur Home Owners Assocationiandrreviewyyour deed or any restrict that
wh ch 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 lender or anittorOy before commencing work or recording your Notice of Commencement. _
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF
COUNTY OF C'd-ty I l
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this ay o Ai� by r y
Name of person making statement.
Person Known OR Produced Identification ��•`. ,0AW/V � ,1,
Type of I ntification Produced -
PUBLIC iJL S5327t1550� �O` `���,•NOTARY 0'L�
YQ. PUBLIC U
(Sig ture of Notary Public- e f Florida) :,MY CotAMISSION ; Q
I t. -11 '1 L_ (Seal) : O EXPI � �.
Co mission No.'7 ?-- Q?
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