HomeMy WebLinkAboutBuilding Permit Application 04/04/2016 11:08 7724612036 STEVE SMITH AC PAGE 02/03
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l� Permit Number: d b
RECEMSD APR 0 4 2016
Building Permit Application
planning and Development Services
Building and Code Regulation Division
2300 t6liginia Avenue,port pierce FL 84982
Phone:(772)462-1553 Fax: (772)462-1.578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Legal Description:
Property Tax ID#: r�/t �'C� Lot No. -
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Name�•� - �'i-� �� �/ Name: Steve Smith
Address: Company: leve Smith Air Conditioning
• 8001 Eden Rd
city: /.jr�rr _State: Address. '
Zip Code: r;0 f1 Fax:
City. pod Pierce State:FL,
Zi Code: 34951 Fax: 772 461-2036
Phone No. ;?/' p
E-Mail: Phone No. 772 461-1425
Fill in fee simple Title Holder on next page(if different E-Mail:stevesmthac@aol.com
from the Owner listed above) State or County License: CACI 813454/20071 _
if value of construction is$Z500 or more,a RECORDED Notice of Commencement is required.
04/04/2016 13:18 7724612036 STEVE SMITH AC PAGE 01/01
DESIGNER ENGINEER: Not Applicable7Address:
MORTGAGE COMPANY: Not Applicable
Name: Name:
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-
I certify that no work or installation has commenced.prior to the issuance of a permit_
St.Lucie Coant,�makes no representation that is granting a pertnit 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 5t.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 your paying twice for
improvements to your property.A Notice of Commencement mast be recorded and posted on the jobsite
before the first inspection.if you intend to obtain financing,consult with lender or an attorney before
commencing rk or rerwding your Notice of Commencement.
s
signature of Cfwnerl Lessee/Agent Signa#ure of Co tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY Of
The fo oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
Ms T day of '1�1ryS . 20 I�bY this�day of i1►11� .20�by
A n
r
--
(Name of person acknowledging) (Name of person acknowledging)
(signature of Notary Public-State of Florida) (Signature of Watary Public State of Florida)
Personally Known _OR Produced Identification Personally known _OR Produced Identification
Type of Identification Produced Type of identification Produced _
Commission No. � E�V M M fission No. (Seal)
STATE OF FL IDA t[OTARY PUBLIC
STATE OF FLORIDA
Remised 07/15/2014 � E*L t 5117=19 CCA OFM1202
5!17/8019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS