HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r L_
Date: 6/1/.,16 Permit Number: �0 0 0 l�
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Building Permit Application JUN 0 2 2016
Planning and Development Services
Building and Code Regulation Division PEPif ITTiNG
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED IMPROVEMENT LOCATIO
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Address: 6205 FORT PIERCE BLVD
Legal Description: LAKEWOOD PARK-UNIT 6 BLK 63 LOT 13
Property Tax ID#: 1301-606-0121-001 Lot No.
Site Plan Name: Block No.
Project Name: CHRISTOPHER SMITH
Setbacks Front Back: Right Side: Left Side:
TAILED DESCRIPTION OF WORK: t:
AC CHANGE OUT A 3.5 TON YORK SYSTEM
CDNSTRUCTICIN INFORMATION
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work to be nertormed under this permit—checkec a app y:
Z✓ HVAC Gas Tank E]Gas Piping _Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers Generator L Roof
Total Sq. Ft of Construction: 15,589 S . Ft.of First Floor:
Cost of Construction:$ 4300 Utilities:Sewer ElSeptic Building Height:
t3UUNERILESSEE CONTRACTOR
Name CHRISTOPHER SMITH Name: THOMAS A SMITH
Address:6205 FORT PIERCE BLVD Company: ALL YEAR COOLING &HEATING
City: FORT. PIERCE State:FL Address: 1345 NE 4TH
Zip Code: 34951 Fax: City: FORT LAUDERDALE State.FL
Phone No. Zip Code: 33304 Fax: 954-617-3798
Phone No. 954-566-4644
Fill in fee simple Title Holder on next page(if different E-Mail: DDANIELS AYCAIR.COM
[E-Mail:
rom the Owner listed above) State or County License: CAC058159
f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIQN LIEN LAW INFORMATION;
_ ,
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:
Add re ss: 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 County makes no representation that is granting a permit will authorize thepermit 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 your paying 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, consult with lender or an attorney before
commencing work or recording our Notice of Commencem
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ignature of Owner/Lessee/Agent S gnature of Contractor/Lice se Ho er
STATE OF FLORIDA TATE OF FLORIDA
COUNTY OF SAINT WCIE COUNTY COUNTY OF BRO—RD
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1 day of JUNE 20 16by this ' day of JUNE 20 16 by
THOMAS A SMITH
(Name of person ackno ing) (Name of acknowledging)
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( ' a of Nota ublic- ate of Flo r' a ,. �c" o`L t of ry Public-St cCfj I�;i atp eyo
Personally Known OR Pro c Personally Known1. Ification T
Type of Identification roduced ♦ (� c. Type of Identification Pr do�
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Commission No. rl 2,4VS Commission No. ° " (Seal)
Revised 07/15/2014 1`•�. ` ����
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS