HomeMy WebLinkAboutBuilding Permit Application 03/30/2016 07:12 7724612036- STEVE SMITH AC PAGE 02/03
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED o7—
Date: �
�6 Permit Number: J
• Building Permit Application
Planning and DevelapmentServices
Building and Code Regulation Division
23W Virginia Avenue,Fair Pierce'FL 34982
Phone:(772)462-1553 Fax:(772)462-1.578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line
Address:
Legal Description:
Property Tax In#: i'�D/ � dDD�/ Lot No.
Site Plan Name: Block No. /O
Project Name:
Setbacks Front Back: Right Side: Left Side:
151
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Additionalwor tone rtnirmed un er this permit—check all th appy:
HVAC Gas Tank ❑Gas Piping _Shutters L_i Windows/Doors
0 Electric �Plumbing ❑Sprinklers �Generator El Roof
Total Sq.Ft of Construction. /ODf/ Sq.Ft.of First Floor:
Cost of Construction:$ Utilities:ElSewerFISeptic building Weight:
Name Tim ��� Name: Steve Smith
Address: ;Wz_� ��r� �e Company: Steve Smith Air Conditioning
City: �J ��r� State: Address: 8001 Eden Rd
Zip Code: 3 �/ _ Fax: City; Fort Pierce State:Fl-
Phone No: Zi Code: 34961 Fes; 772 461-2036
P -
E-Mail: Phone No.772 461-1425
Fill in fee simple Title Holder on next page(if different E-Mail: stevesmthacQaol.Corn
from the Owner listed above) State or County License: CAC1813454/20071
If value of construction is$2W or more,a RECORDED Notice of Commencement Is required.
03/30/2016 07:12 77246120361 STEVE SMITH AC PAGE 03/83
DESIGNER/ENGINEER: -X-Not Applicable MORTGAGE COMPANY: Not Applicable
Name., Name:
Address: Address:
Zip: Phone: Zip., Phone,
X Not Applicable
EE SIMPLE TnUHIOLDER: XNot Applicable BONDING COMPANY:
Name. Name:
Address: Address:
Zip: Phone: Zip: Phone.
I certifV that no work or installation has commenced,prior to the issuance of a permit.
St.Lucie County makes no representation that is granting apermit will authorize the permilt 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 viibich 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,
accessorystructures,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 inay result In your payms twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first Inspection.If you intend to obtain financing,6onsult m(Fth lender or an attorney before
commencing w_ork or repqWing y2yr Notice of Commencement.
signature of C(wner/Lessee/Agent Signature-f Coldractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY 0
The foigoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
(Name of person acknowledging) '(Name of person acknowledging)
1-41 /P,*/ 4 A� 9-4;�
(Signature of Notary Public-Statebf Florida) (Signature of Nicitary Public-State of Florida
Personally Known OR Produced Identification Personally Known -OR Produced Identification
TVpe of Identification Produced_ Type of identification Produced
Commission No. misMon No. (Sea[)
=IZEM OM1111W STATE OF FLORIDA
Revised 07/15/2014 Ewl"anitmo 00
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