HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:—ILPermit Number:
Building Permit application
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772)462-1553 Fax: (772)462-157$ Commercial
Residential '-�
PERMIT APPLICATION FOR: G - — U K
PROPOSED IMPROVEMENT LOCATION.-
Address:
OCATION:Address:
Legal Description:
Property Tax ID #: — tot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
C �C & L J U � -ter e�
1 1(0 s e V- Imo d (Z -U-) e
CONSTRUCTION INFORMATION:
Additional work tojeee Orme under this permit — check affJ appy:
®HVAC I _I Gas Tank Gas Piping _ Shutters Windows/Doors
Electric ElPlumbing 05prinklers In Generator LE Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ c ��• Utilities:Sewer 0Septic Building Height:
OWNER LESSEE:
CONTRACTOR:
Name�,
Name: James Snyder
��
Address:(DID Z &o_ c>— te a: r �%4 -
Company: Snyder's Coating and Heating, fnc.
City:.. 1'�- V 1 Q,n( G'-_ State:
Zip Code: 3 L-1'1 511Fax- �"
Phone No. �a, J ai I 1
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: snyderscoofing aC. aoLcorn
State or County 'License: CACI 8165791 #26414
11 vague Of coristrurTion is :>c�uu or more, a KtLUKUW Notice of Commencement is required.
SUPPLEMENTAL. CONSTRUCTI N LIEN LAW INFORMATION:
DESIGNERIENGINEER: � Not Applicable
Name:
MORTGAGE COMPANY: � Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ NotApplicable
Name:
BONDING COMPANY: _Nofi Applicable
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 theoermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anc� 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, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OlhINEI�• ur failure to Record a Notice of Commencement may result in your paying twice for
improvements to yo�� r') rt y. A Notice of Commencement must be rec ded and posted on the jobsite
before the first in.s `ct' if you intend to obtain financing, Consult wi ender or an attorney before
commencing; wlc,p` o cording your Notice of Commencement.
A
'00�
Sign 'r caner/ Lessee/Contractor as Agent for Owner
01
'46X_.'O�
f Contractor/License Holder
OF FLORID Ir
f �U4c•�
TE OF FLORID
NTY OF
OUNTY OF
The forgoing instrument was acknowledged before me
this day of r,�.� +� 1 ZO I by
The forgoing instrument was acknowledged before me
this 10 day of 20 b by
Name of persors�aking s#atement
name of persosyrnaking sta ement
✓
Personally Known OR Produced Identification
Personally Known OR Produced Identincation
Type of ld�iication
Type of Identification
Produced
Produced
�a►ala9ii #Bl�Pa<��o
(Signature of Notary Public -State of Fior' a *° SOS O/V
JY��A�q
, {Signature of Notary Public -State of FJ�irid? ',io���"'�2? �o ;
~�_
Commission No. r iq 15 5 `�
�F'�
gommission No. JSe4p,
1 ( al
SABRINA L. BLACK OFF 195337
o 195337
sow. %, e 5 • o
SABRINA L. BLACK u;klv
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!►STATE�t�`g\°
REVIEWS
FRONT
ZONING
> 15 �R
FLANS
VEGETATION
SEATURTIL
f����ROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17