HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTER
Date: a 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_ . yL . . 0IJL Ko-- PD-� u K'0__
PROPOSED IMPROVEMENT LOCATION:
Address. -1 7S C-ci b t I a Sq,3 q S,
Legal Description: .ff-1 e.1 I 0- d Co'-, 610
Property Tax ID#: �a 3 57bl Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Might Side: Left Side:
DETAILED DESCRIPTION OF WORK:
[Lid he-A.
co JSTR ICTION INFORMATION:
Additional work to be i3ertarmed under t is permit—checka apply:
HVAC Gas Tank F_JGas Piping QShutters Windows/Doors
MGenerator
Electric L_1 Plumbing 0Sprinkiers Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ d. e utilities: l=J Sewer O Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Q-Y Name: James Snyder
Address: 0 � 3 CCNCj 1 JR'(_ Company: Snyder's Cooling and Heating, Inc.
City: a- P, tXC i- _ State: r r, Address: P.CJ. Box 2007
Zip Code:. j44 9 9,S Fax: City_ Fort Pierce State:FL
Phone No. -7-7ai - vZ d Zip Code: 34954 Fax: 772-600-4811
E-Mail: Phone No. 772-528-3377
Fill in fee simple Title Holder on next page (if different E-Mail: snyderscooling@aol.com
from the Owner listed above) State or County License: CAC1816579/#26414
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTI LIEN LAW INFORMATION:
DESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY: _ of Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone I Zip: Phone:
FEE SIMPLE TITLE HOLDER; of Applicable BONDING COMPANY: _ of Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNED/ 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 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. 'lease 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 perty. A Notice of Commencement must be recorded and posted on the jobsite
before the first ins - . If you intend to obtain financing, consult wit nd or an attorney before
commencingwok�o cording our Notice of Commencement.
5i u of Owner/Lessee/Contractor as Agent for(Owner ure of Contractor/License Holder
5 TE OF FLORID STATE OF FLORIDA
COUNTY OF 1. �u�� 2� COUNTY OF � .
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledge�efore me
this--5day of � 2t]� by j this 25day of'�. 20L by
cam /
Name of person aking sta ement Game of person kin—g_statemenit
me
Personally Known�OR Produced Identification Personally Known ✓' OR Produced Identification
Type of identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida J
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR I PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW I REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/37