HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -1 ! � l Permit Number:
i
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578Commercial Residential
PERMIT APPLICATION FOR: Tn s
PROPOSED IMPROVEMENT LOCATION: L e_
Address: 5Gal ))nix— CA 41 i2
Legal peseription; ZJ�;L CD – t ci �.i– " v�4� I A"
Property Tax ID #: Lot No._
Block No.
Site Plan Name:
Project Name:
Setbacks Front Back: might Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
itiona wor to e er Dime un er t is permit — c ec a app y:
L'� FIVAC fn Gas Tank E]Gas Piping Shutters
11Electric I:j Plumbing E]Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $`i
OWNER/LESSEE:
S Ft. of First Floor:
Utilities: FISewer O Septic
Name Y 7(i fSh ne- iiC 1T,Qi-
Ad d ress:?�Z—� ,� i uY ► ( - l 3
City: f4. P .t..•Y e.- State:
Zip Code: _77�)�ACA'2,JL Fax:
Phone No. i - LO 64—
E-Mail:—
Fill
E-Mail:Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Windows/Doors
Roof
Building Height:
Name: James Snyder
rmmn:4nNr. Snyder's Cooling and Heating, Inc.
Roof pitch
Address: P•0• Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Phone No. 772-528-3377
F-\Aaii. snyderscooling@aol.com
State or County License: CAC1816579 1 #26414
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAVH INFORMATION:
®ESlGNERjENGINEER;
Blame:
Not Applicable
MORTGAGE COMPANY-
Name:
� Not Applicable
Address:
COUNTY C}F�-
Address:
The forgoing instrument was a knowledged afore me
this �1 day of 20��6y
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE iiO4.D1=1;:
Name:
%-I Not Applicable
RQi1l�71�1C COMPANY:
Name:
x--PCfot Applicable
Address:
Address:
��'Signature of Notary Public -State of Flarid~s ' �
City:
Commission AV ����K ��f�� ���d�'�F`c�q�
4'l�i l��%i
City:
STA��Q
l��Fl/�1N 1111111\\\
Zip: Phone:
FRONT
Zip:. Phone:
SUPERVISOR
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 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 i pection. If you intend to obtain financing, consult with der or an attorney before
commencin t)r recordin our Notice of Commencement.
r
Rev. 8/2/27
re of Owner/ Lessee/Contractor as Agent for Owner
of Contractor/License Halder
OATE
ATF OF Fl.OR1
COUNTY OF
OF FLOR1
COUNTY C}F�-
The forgoing instrument was acknowledged before me
this day of ��j� , 2D� by
The forgoing instrument was a knowledged afore me
this �1 day of 20��6y
V �, �e�1/
�Yl.�d +e�
Name of person malung statement
Personally Known v/ OR Produced Jdenti#ic �� a3ilSiiPo)i`E°t
����
Name of person making statement
Personally Known tI OR Produced ldentifir.\�,�jq}i}91#IlN
Type of identification 15SI�.+'�,�•
Produced
,.Type of Identification '`
Produced
.•y�da[Y2,2"Sof•�
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#FF 195337
(SignStAra�fll��i-�Pi��r�e of Florida�„��.`���,�de�tn� • �� �
��'Signature of Notary Public -State of Flarid~s ' �
Commission No. �"� � Seal�r'���,°r ST�
i��'' 161 ��� �I
Commission AV ����K ��f�� ���d�'�F`c�q�
4'l�i l��%i
STA��Q
l��Fl/�1N 1111111\\\
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
GATE
COMPLETED
Rev. 8/2/27