HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: �� Permit Number:
_M_ Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial C181
PERMIT APPLICATION FOIA: ,AIC. ch, - crii P�
PROPOSED IMPROVEMENT LOCATION:
Address:62S6 .
Legal Description:
Property Tax ID : �I2.p'gba,- M5L4
Site Plan Name:
Project Name:
setbacks Front Back: Right Side: Left5ide:
DETAILED DESCRIPTION OF WORK -
CONSTRUCTION INFORMATION:
A:trona wor to e e arms un ert is permit- c ec a
HVAC Gas Tank []Gas Piping _ Shutters
Electric LJ Plumbing Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction- $A
j OWNER/LESSEE:
SQ. Ft. of First Floor:
utilities Sewer E]Septic
Name
Address:&;A90g
City: C�, i k-11C4,f-- State: F-1
Zip Code: SL)97 Fax:
Phone No. T7
E-Mail:—�
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
E
Lot No. -7
Block No. 5
IlWindows/Doors
Roof = Roof pitch
Building Height;
Name: James Snyder
Company: Snyder's Cooling and heating, inc.
Address: P.O. Box 2007
City: Fort Pierce State: FL
Zip Code:
34954 Fax: 772-600-4811
Phone No. 772-528-3377
E -Mail: snyderscooling@aol.com
State or County License: CACIS16579 I #26414
i value cif construction is $2500 or more, a RECORDED �lotice of Camrriencement is required.
SUPPLEMENTAL CONST RUCTi
N LIEN LAW INFORMATION:
IDESIGNER/ENGINEER:
Not A licable MORTGAGE CC3 RANY: ,/Not Applicable
pp
Name:
Na
Address:
Address:
Address:
State: City: State:
City:
Zip: Phonealp'
Phone:
�'�
EEE. SIMPLE TITLE HOLDER:�
Not App llcable BONDING COMPANY:� of Applicable
Marne:
Marne:
Address:
Address:
city:
City:
Zip. Phone:
Zlp: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to Obtain 2 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-
lder to
St. Lucie County makes a representation
ep plicablelHome OwnersAssociationAssoclat onlt will rules, or and covenanermit ts that maydrestr subject
pro lbit such
which is in conflict with any applicable
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may appy.
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 Capes 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 Mice for
improvements,to your property. A notice of Commencement must be recorded and posted on the Jobsite
before the f t spection. if you intend to obtain Financing, consul ith lender or an attorney before
commen�g. ork or recordin our Notice of Commencement.
of Owner/ Lessee/Contractor as Agent for Owner,
STATE CIE ELORIDIA
COUNTY OE j- �--LA- e1
The f r Ding instrument was acknowledgepefore me
20 1 by
Marne of persorymaking statement
Personally ' ✓ OR Produced Identification
Type of Identification
Produced
r��r►tilloitlflt��yr
(Signature of Notary Public -State o 10— ;ay 2,2D0��
Commission o_ rG
�rf
Ig6.. L3 mf @1 e*
y�` ° FF 195337 : o
r' 'l!NA L. BLACK
LREFRONT ZON1[(iii��dPp�11ISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED '
I DATE
CO Ni P LETE D
Rev. 8/2/'L7
of contractor/],.cense Holder
STATE OF FLORID
COUNTY CSE Lwc.r eJ
The forgoing instrumen was acknowledged before me
this clay of [ _20 L9 by
Name of per alcing statement
Persona{l!� OR Produced Identification
Type of identification
Produced
��°� �, L. ��C E✓re°oo
(Signature of Notary Public- State of FWida.���o�°
�o �'A
Commission No. FFIG1 �3�7*eal]�`
° tFl,195337 .'
4 SABRING L. BLACK �O�•,'��a�onaed�h�c";'��6Q:
I • ae
PLANS VEGETATION SEA TURTLE° � � U+bVE
REVIEW REVIEW REVIEW REVIEW