HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLIIC. BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `71 1i Permit Number:
Building Permit Application
Planning and Development Services I
Building and Code Regulation Division
2300 Virginia Avenue, Port Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1575 Commercial Residential ✓
PERMIT APPLICATION FOR: Al C Cham(90 I` k/
PROPOSED IMPROVEMENT LOCATION: # l'
Address: Aoc)-7n a-A6LJ.
Legal Description: n µ I l td � % c�. 1M� ��LY
Property Tax ID #: I q rs(p - ko I - b o-7 3 — 0b -1 Lot No.
Site Plan Name. Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
A) C C�� aal— L; Ko- 6'� LV_
coo v C I Q,V A. 6 in V, , / (o s ✓ Sly S �ewA vJ i 4--� C'b I�_'Lu
CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit —check all that appy:
®HVAC Gas Tank Gas Piping Shutters ❑ Windows/Doors
Electric 0Plumbing OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 5Ft. of First Floor:
Cost of Construction: .$ . a&D � Utilities.tSewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name P__
Name:.lames Snyder
Address: GtjirL- Li
Company_ Snyder's Cooling and Heating, Inc.
City: State: C1
Zip Code:�� Fax:
Phone No. Lv ( g
Address: P.O. Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Phone No. 772-528-3377
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: 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.
OWNER/ C®NTRACTOR 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 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 yo property. A Notice of Commencement must be re orded and posted on the jobsite
before the first in ec n: If you intend to obtain financing, consult w ender or an attorney before
cDrnmencin w k recordin our Notice of Commencement.
Rev. S/2/17
SUPPLEMENTAL C�NSTRUCTIO LIEN 1A11iI 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:
Sig Owner/ Less ee{Contractor as Agent for Owner
tura of Contractor/License Holder
ST E OF FL, ®
STATE
STATE OF FLORID,,BB�� I
UNTY Oi=�
COUNTY OF�
The forgoing instru ant was acknowledged before me
� (
The forgoing instru .ant wa acknowledger�Pefore me
this day of i 2i7_ by
this � day of 20 by
Name of perso aking sta ement
Personally Known
Name of person ak g statement
Name:
_Not Applicable
BONDING COMPANY:
Name:
I✓iCfot Applicable
Address:
Produced �+�yiili#iR##8llf
Address:
City:
City:
{signature of Notary Public -State of Fl�� *"'r '-
Zip: Phone:
SASi`?IiVe� 9��'3i
__111
Commission 3 -7
Zip: Phone:
No. �
OWNER/ C®NTRACTOR 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 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 yo property. A Notice of Commencement must be re orded and posted on the jobsite
before the first in ec n: If you intend to obtain financing, consult w ender or an attorney before
cDrnmencin w k recordin our Notice of Commencement.
Rev. S/2/17
SUPPLEMENTAL C�NSTRUCTIO LIEN 1A11iI 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:
Sig Owner/ Less ee{Contractor as Agent for Owner
tura of Contractor/License Holder
ST E OF FL, ®
STATE
STATE OF FLORID,,BB�� I
UNTY Oi=�
COUNTY OF�
The forgoing instru ant was acknowledged before me
� (
The forgoing instru .ant wa acknowledger�Pefore me
this day of i 2i7_ by
this � day of 20 by
Name of perso aking sta ement
Personally Known
Name of person ak g statement
OR Produced Identification
Personally Known 1�OR Produced Identification
Type of identification
Type of identification
Produced ,\���r•SABRf11,lq
��,131i419#1#PryJ.IV
Produced �+�yiili#iR##8llf
(signature of Notary Public- State a'fzlbrida)��® � � � o
{signature of Notary Public -State of Fl�� *"'r '-
Cors��l ,�2�'� �� ��F 5 =
f�f9A:5ia��
SASi`?IiVe� 9��'3i
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Commission 3 -7
No. �
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STATE
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1141
REVIEWS
FRONT
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SUPERVISOR
` PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
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REVIEW
REVIEW
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REVIEW
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DATE
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DATE
COMPLETED