HomeMy WebLinkAboutMonizPermitSLC_20220316All APPLICABLE I WO^ ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �6 Permit Number:
Building Permit Application
Planning and Deveiopment Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE: HVAC Equipment ChangeOut
Address:
Property Tax ID
Site Plan Name:
Project Name:
Like for like AC replacement
AddZechanical
al work to be performed under this permit- check all that apply:
— Gas Tank _ Gas Piping _ Shutters
Lot No
Block No.
—Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of construction- Sq. " Sq. Ft. of First Floor:
Cost of Construction: $ J` Utilities: _Sewer _Septic Building Height:
Name _ ✓�-�'���� ice'
Address:
City: v %l! State:FL
Zip Code: 7�% i/ 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.
�34
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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 conflicts with anY applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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
..L I__J_.- _ , 6.r.f- .- mmonri na %Ainrie nr rPrnreiing vnilr Nntire of Commencement.
W11.I1 IC11UC1 41 C71J au 111cy uciv'c
oirsY °�e� •.: ANGELA CHRISTINE SRAGG
Signature of ractor - or - Owner Builder as applicable Notary Public State 6 Florida
®aP; Commission 4 HH 068084
My Comm. Expires Mar 28, 2025
STATE OF FLO D
COUNTY OF �If- 1J1LyA-
Swor to (or affirmed) and ubscribed before me of �/
2051by
T
Physical Presence or Online Notarization
((��
this day of , ,S�-CV e-A
1Pt . S ►M) j
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary Public -State of Florida)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21