HomeMy WebLinkAboutHaukPermitSLC_20220302All APPLICABLE I FO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ; 2 ZZ 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
Address: Z) /-/ Y /`/�✓ 1fn1lrve-o'
Property Tax ID #: / ,T/ `��/�I VVy�o _ Z
Site Plan Name:
Project Name:
Like for like AC replacement
Lot No.
Block No.
Additio al
work to be performed under this permit— check all that apply: :' Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
_ Electric _ Plumbing/ _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Name 61,"A/w 7aN/r
Address: �7,�py I
City: 4 State:
Zip Code: Fax:
Phone No. 77Z-
E-Mail:
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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-Mails tevesmithac@aol.com
State or County License CAC1813454
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 in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association 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 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 lendor or anittorOy before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF F69R49A
COUNTY OF
Sworn to (or affirmed) and subscribed before me of _-'-,�ysical Presence or Online Notarization
this�dayo 20'1 by
r
Name of person making sta ement.
Person Known OR Produced Identification .`� DAWN
Type of I ntification Produced C-'l1 DL S530 7$I S50% �O` `�`��P NOTARY do, '
•
�� ' PUBLIC .SUP
YJ
(Sig ture of Notary Public- e f Florida) : MY GOMMISSION
: O '• EXPIRa�.' 2
Co mission No.i7t.1'1 1l. (Seal) ' ?� ' , ! —. G
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 5/20/21