HomeMy WebLinkAboutZacharPermitSLC_20220309All APPLICABLE I F UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
aZ 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:
Property Tax ID #
Site Plan Name: _
Project Name:
?#-, 6
�e _ fo1 _65!� -lioD-7
Like for like AC replacement
Lot No.
Block No.
Ad ditii nal work to be performed under this permit— check all that apply:
X1/ Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
����/
Cost of Construction: $
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Name
Address:
City: I ili'lY State:/=�
Zip Code: 3145r/ Fax:
Phone No.
E-Mail:
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-Mail stevesmithac@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.
"DESIGNERNGINEER: _ 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
wh ch ay applyhibit such
or restrict that
with pyoiurHome Owners AssAssociation
leasle consulany.any
structure. conflict
c ationland reviewyyour deed
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,
and accessory uses to another non-residential use
accessory structures, swimming pools, fences, walls, signs, screen rooms
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
must be recorded in the public records of St.
improvements to your property: A Notice of Commencement
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with len or a tt before commencing work or recordingour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FE0RID
COUNTY OF 06.y-.l
Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization
this 1d20jbyy
T,
7k_
Name of person making sta ement.
Person Known OR Produced Identification ��•` PDAWN ��'•,��
r-LI DL 530 71SIS50%a.0
Type of I ntification Produced --�-- ,•-' NOTARY
PUBLIC N
(Sig ture of Notary Publicl-Stetfkf Florida) :.MY COMMISSION. Q
O EXPI tia�.
Co mission No.'71li- 1'1 '3-L., (Seal) ? ••, ,•. �'
��'o,��EALTN OF�:•:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21