HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Q 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: AI (. o
PROPOSED IMPROVEMENT LOCATION:
Address: q al
j �-,�I I t �S �-- �V ✓
Legal Description: CW+_ r �aA1` e1 �5 1kni
Property Tax ID #: ;} `91-7 — p - 00z) — POP — � � Lot No. I
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
®® f�
CONSTRUCTION INFORMATION:
Additional work toe e Orme under tis —checkpermit a apply:
®HVAC Ei Gas Tank DGas Piping_ Shutters Windows/Doors
11 Electric 1:1 Plumbing Sprinklers I Generator E]Roof Roof pitch
Total Sq_ Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ Utilities:Sewer ❑Septic Building Height:
OWNERILESSEE:
CONTRACTOR:
Name D
Name: James Snyder
Address,- /-%DQ 1 J /L
Company: Snyder's Cooling and Heating, Inc_
City: i' - �� PXL. State:
Zip Code: Fax:
Phone No. _7_701 to
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: GAC1816579 / #26414
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTI N LIEN LAW INFORMATION:
DESIGNERIENGINEER: / Not Applicable
Name:
MORTGAGE COMPANY: � Not Applicable
Nage:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
EEE SIMPLE TITLE HOLDER: ✓ Not Applicable
Name:
Address:
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 and installation as indicated.
1 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 rules, bylaws or anti 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 1 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 OW R: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements t your p perty. A Notice of Commencement must >erec ed and posted on the jobsite
be€are the firs °.nspe on. if you intend to obtain financing, consulender or an attorney before
rnmmQnr.irn€t tnrlc. r rernrding vnur Notice of Commencement.
Rev. 8/2/17
of Owner./ Lessee/Contractor as Agent for Owner
ure of Contractor/License Holder
TE OF FLORIDA
i^kC�l
STATE OF FLORIDA -
UNUNTY i]F 'S - CsCOUNTY
OF
' the fo going instrum t was acknowledgejbefore me
The for oing instrume w s acknowledged fore me
this day of u 2Q I D by
this day of 26-L
r�
M,4 cV-
Name of person king state ent
Name or person ng statement
Personally Known OR Produced Identification
Person own t�OR Produced Identification
Type of Identification
Produced
Type of Identification
Produced
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"iSignature of Notary Public - St to of FloriN ; $ k. `c
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{Signature of Notary Public -State of Flora �•' , am cr
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-_ SABRIINI S. 9
5 36 #FF 195337 '
Commission No.7VP_ #FF 195337
=ammission No.l)
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I/14141431N�
REVIEWS
FRONT
ZONING
SiSOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17