HomeMy WebLinkAboutDacey - 9104 Short Chip Cir SLCALL APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: tX 14A 1119 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: At c, akDLJ V'Q_
PROPOSED IMPROVEMENT+_ LOCATION:
Address: t C4 5 z)rT za i i( P'
Legal Description: 5 _CGA- V G
ICLb,Lal-57
0
Property Tax ID#: ]`� �d l ' r� '"� "� Lot Na5-7
._,
Site Plan Name. Block No. _
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
41 C_ () LJ - U, K LA Kz_
bcoxnaNn C5 1 -a -) 1(o s
CONSTRUCTION INFORMATION:
Additional workto e e orme un er this permit- check a appy:
L°'..]HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
Electric IJ Plumbing Sprinklers Generator IJ Roof Roof pitch
Total Sq. Ft of Construction: �
Cost of Construction: $ A`7
S.�Ft.jj of First Floor:
Utilities: nSewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
G
Name LZLWVaja���,
Name'. James Snyder
Address: D�� Y
Company: Snyd&s Cooling and Heating, Inc.
City: P'5 — State:1.
Zip Code: C_314%Lo Fax:
Phone No. 63 -SZ [ z
Address: P.O. sox 2aa7
City: Fort Pierce State: FL
Zip Code: 34654 Fax: 772-600-4811
Phone No. 772-528-3377
E -Mail: r'-
Fill in fee simple Title Holder on next Page (if different
from the Owner listed above)
E -Mail: snyderscooiing@aol.com
State or County License: CACI 8165791 #26414
If value of construction is $2500 or more, a RECORDED Notice oT 1-ommencemeni is regwrea.
SUPPLEMEN TIAL CONSTRUCT N LIEN LAW INFORMATION:
DESIGNERJENGINEER: _ Not Applicable MORTGAGE COMPANY, _ Not Applicable
Name:
blame:
Address:
Address:
City: State:
Zip: Phone
EEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
I BONDING COMPANY: Not Applicable
Name:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worK an❑ insranauwii as mutUaLc_U.
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 holderto 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 Horne 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
WARN Ii' G TO OWKZrLzr�n�rrjinrr
-Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to yperty. A Notice of Commencement must he record , nd posted on the jobsite
before the first i if you intend to obtain financing, consult with r or an attorney before
vnlir Nlntit•P r)f �'nST1mPnrPrnPnt.
i.VllilllCflLlll 4 6l ! iV+-•Ya Ylaa Yv• acv u•+ -•—•v �-�••••-------------.
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Si of Owner/ Lessee/Contractor as Agent -For Owner
re of Contractor/License Holder
E OF FLORID
STATE OF FLORID d1
�c�,
�wLA e_
COUNTY OF �7^ v
t� NTY OF t I
Th r oing instrur nt was acknowledged before me
day u�-t 261, by
The forgoing instrument was acknowledged efore me
this � day of 201 by
thi� of
-�Q�-e ( E��ri�liteir
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Name of person aking s atexr�-' b �r®
Name of arson}� akin stateme�µ nt �daijjip
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OR Produced I�a•.
Personally Known OR Prod�iy—
Personally Known i%
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i Type of Identification era ��9 s •
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T e of Identification a �?r�I•".��
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Produced '5v Zn
Produced v`
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(Signature of Notary Public- State of FI°d41r IjPUBUrG So>4
(Sign tr f� iAttft
l r Pe of Flori gipUB;ub;:���
SABRINI �7 (Seal)
+
Commission No. r 19 533-7 (Seal)
Commission No /
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/7.7