HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
J. _
w
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F! 34982
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: 41c 0 Lt� L ie t__ �
PROPOSED IMPROVEMENT LOCATION:
Address: 1,551 1 m e -v 1 L.
Legal Description: ! 1 SUP y-[ e_ E t T o—+e-s Lbf 7
Property Tax ID #: D" 1 nb I C� - Lot No -
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: ,r
C_ Oqa"'-� O-VJ - L k
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CONSTRUCTION INFORMATION:
Additional work to ertormed under this permit —check a app pp
®HVAC t =1 Gas Tank ❑Gas Piping _ Shutters Windows/Doors
L Electric L_J Plumbing 0 Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ��---��
Cost of Construction: $ q !SLI
5 Ft. of First Floor: —
Utilities: El Septic
Building Height:
OWNERAESSEE:1
CONTRACTOR:
Name t 2_ LQ
,,``
l(�i �%!
Name: James Snyder
Address:
C? +I j f ;
Company:Snyder's Cooling and Heating, Inc.
City: &
Zip Code: �� Flax:
Phone No. TM�t
State: EL
a q
D�/��_
Address: P -O. Sox 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Phone No. 772-528-3377
,Y
E -Mail:
Fill in fee simple Title bolder on next page ( if different
from the Owner listed above)
E -Mail: snyderscooling@aol-com
State or County License: CAC18165791 #26414
if value of construction is $2504 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
i Zip: Phone
City: State:
Zip: 'hone:
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:
BONDING COMPANY: ,Not Applicable
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 thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association ruses, 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 pians, 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 your property. A Notice of Commencement must be reco ded and posted on the jobsite
before the f' it Xection. If you intend to obtain financing, consult wit ender or an attorney before
cowmen ' or recordina vour Notice of Commencement.
Rev. 8/2/77
n e of Contractor/License Holder
e of owner/ Lessee/Contractor as Agent for owner
VATE
OF FLOR ��
ATE OF FLORID
COUNTY OF
COUNTY OF
The fgcgoing instr nt w s acknowledged efore me
1
The f�oing instrj ent w 5 acknowledged fore me
this day of } 2a y
this . day of r , 2Q by
6wjev
d C'V-
Name of person king statement
Name of person king statement
Personally Known 1 IR Produced identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification `�4��y1Sli11lif1111
Produced
S81
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Produced �,�e� SpBRIIVJC-
04;
of Notary Public -State of Florida
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(Signature of Ript ry P li - to of FbriTa�Q `` k -n.
SAB I �I •�� :
Commission No. �� � 7 [ I'� � #iF195337
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REVIEWS
FRONT
70NING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
®ATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/77