HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 349$2
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: D i
,�� � r PJ1,�G2 .
Legal Description: c�
e- ft) CO) Lo DOOL
Property Tax ID #: -62�
Site. Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
C�e-
�.5 1Co. S 5e�� Ls 12 Kw
CONSTRUCTION INFORMATION:
A itiona wor to e e arms un ert is permit—cnec a
QHVAC n Gas Tank FIGas Piping
11 Electric Q Plumbing Sprinklers
Total Sq. Ft of Construction:
Q
Cost of Construction: $ bL5,
I OW N ERILESSEE:
Lot No.
Block No.
apply:
Shutters Windows/Doors
Generator Roof = Roof pitch
Sq. Ft. of First Floor: _
Utilities: Sewer E]Septic
Name u, u i�
Address: 0
City: t State: .
Zip Code: ci ,2- Fax: -�—
Phone No. �� " A LI a , 2
E -Mail:
Fill in fee simple Title }colder on next page ( if different
from the Owner listed alcove)
CONTRACTOR:
Building Height:
Name: James Snyder
Company: Snyder's Cooling and Heating, Inc_
Arlr7racc• P.0, Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Phone No. 772-528-3377
r:_nn,;i. snyderscooling@aol.com
State or, County License: CACI 816579 I #2.6414
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENT AL CODS T RUCTI
€ ESIGN
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip; Phone:_
LIEN LAW INFORMATION:
of Appli
State:
LANot Applicable
t1 ORTGAGE COMPANY_ t/Not Applicable
Name:
Address:
City_ State: _
Zip: , Phone:
BONDING COMPANY- —Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFtDVIT_ 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 iconflict with any applicable Horne owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu4t with your Home Owners Association and review your deed for any restrictions which may apply
n.
In consideration of the granting of this requested permit, ! do hereby agree that € 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, wails, signs, screen rooms and accessory uses to another non-residential use
WAI:I�IiNG TO �3;fiJiiil flr ilure to Record a Notice of Cornner�cerrtent may r it in your paying twice for
improvements to y, p rt A Notice of Commencement must be red ed and posted on the jobsite
before the first i on. If you intend to obtain financing, consult w' er or an attorney before
commencing.},,�or r recordin our Notice of Commencement.
Zell
of Owner/ Lessee/Contractor as Agent for owner
STATE OF FLO R1OA M
COUNTY OF � . I.- LA–c l e–
The foriitws ckaw€edgeng nstrumer�efore me
this day of�i-1 _, 2q! " by
0..VY1i? S
Name of person aking statement
Personally Known > OR Produced Identification
i ypey Tofica
`e tition
Produced
of Contractor/License Holder
STATE OF FLORl � �,►� �e1
COUNTY OF
The forgoing instryme t was acknowledge efore me
this day of ZO tiby
A"r
Name of person along aternent
Personal€v Known OR Produced identification
Type of Identification
Produced
9 �f ,11V , i„ &"*'
III „ �"Omw till will
�Q,1�`�Fh, itis �' ��%f/� �--•--�o�' f��1f]j�`'°�_
(Signature of Notary Public- State of Floris j *®p'Nutyx �; (Signature of Notary Public -state oft srd�a .
comm€scion No.EE �3i
Commission. o. _ . .o.m � �,,,•ey
=ti: #Fi 195337 = SABI' INA Lo BLACK %�������a;,,,�4��.,:4��
SAl3fl�$Ae BLACK :p i� p .,u6,Lu�de,„. o s
NINGt ` PLANS VEGETATION SEA TURTLE `'i��FA€ OVE
REVIEWS COUNTER ROVING ��t
FRONT REVIEW REVIEW REVIEW REVIEW'
1
DATE
RECEIVE)
DATE
COMPLEr ED
Rev. 8/2/17