HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �as� 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: C
PROPOSED IMPROVEMENT LOCATION:
PP
Address: O h- C_i U�
Legal Description:
Property Tax ID#: 14A g ' ! Lot No.3 `a S
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
az��ma, p2.,S
CONSTRUCTION INFORMATION:
Additional work to e performed under t ispermit—check all that apply:
Fv�HVAC Gas Tank ❑Gas Piping _Shutters E]Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ r Utilities: Sewer Eheptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name b W Name: James Snyder
Address: d3O9 c fJ Company: Snyder's Cooling and Heating, Inc.
City: 61. e, .vN-&-e— State: 11�-_I• Address: P.O. sox 2007
Zip Code: 314!7q Lo Fax: City: Fort Pierce State:FL
Phone No. `7-7a : —7q.a S Zip Code: 34954 Fax: 772-600-4811
E-Mail: Phone No. 772-528-3377
Fill in fee simple Title Molder on next page (if different E-Mail: snyderscooling@aol.com
from the Owner listed above) - State or County License: CAC18165791#26414
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMEN IAL CONSTRUCT ON LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE.COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
9
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY, _Not Applicable
Name: 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 the permit holderto build the subject structure
Which is in conflict with any applicable Horne 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,wars,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 yourorloperty. A Notice of Commencement must be recorded and posted on the Iobsite
before the first inspe"cti . If you intend to obtain financing, consult wit ender or an attorney before
commencingwork orrdin our Notice of Commencement
5i "a of owner/lessee/Contractor as Agent for owner ure of Contractor/LFHder
ANTE®F FLORID _ STATE OF FL®RIDA
5t
COUNTY OF �e e c. e� COUNTY OF �
The forgoing instrum t was acknowledged before me The forgoing instruFr ent was acknowledged efore me
this day of Tu-�-�� 20 1 by this 1= day of J lk 20 by
Name of perso aping statement Name of personrT�aking state ent
Personally Known �OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
id III fill/
1 INQ�9l�� eej�
(Signature of Notaf uLlic,vtAt Florida "�G �t��ry�2 °� {nature of Notary Public-State of FloAa J•'��' b�uarY2, �;•.
Commission No. 9633 I Al) No. S(Sear
#FF 195337 v --`o:, FF 195337
eeee SIC,STATE��� �fe o�� STATE
REVIEWS FRONT ZONING S gofyl FLANS VEGETATION SEATURTLE AiA4 VE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.S/2/37