HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I`� Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34.482
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: A-1 c
PROPOSED IMPROVEMENT LOCATION:
Address: c0 b0
Legal Description:
Commercial Residential
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Property Tax ID #: L3JDA - (A9 - D01(,Q(-Q - DOD - L4
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LJ -Pc,, L K Q-- I
e -i S�e�" 10 k ne-jev
J
I� I K S9
Lot No.
Block No. C59
CONSTRUCTION INFORMATION:
Additionalwor to e e orrne un ert is perIF1t—c ec a apP Y
I'� !HVAC 11 Gas Tank FGas Piping _ Shutters (� Windows/Doors j
11 Electric 0 Plumbing Sprinklers Generator I Root` I I Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ J ��
OWNS
LESSEE:
Name
Address:
1)
Sq. Ft. of First Floor: _
Utilities Sewer O Septic
City: State:! _
Zip Code:`Fax:
Phone No. 7 of
E -Mail: �rI
Fill in fee simple Title holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: James Snyder
Building Height:
r�T„nnnw Snydees Cooling and Heating, Inc.
P.O. Box 2607
City: Fort Pierce State:FL
Zip Code: 34954 Fax: 772-600-4811
c)knnc 111n 772-528-3377
�-wail• snyderscooling@aa].Com
State or County License: CAC18165791 #26414
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONST IRU
NEER:
Name,
Address:
City:
Zip: Phone.
FEE SJNgPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
N LIEN LAW INFORMATION:
—Not Applicab
State:
Not Applicable
MIORTGAGE COMPANY: -"Not Applicable
Name:
Address: State:
City:
Zip: Phone:
BONC3ING COMPANY: -'Not Applicable
Name:
Address:
City:
Zip: _ Phone:
{] NER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as inriicated_
I certify that no work or installation has commenced prior to the issuance of a permit.
St, Lucie County makes no representation lme Owners Assoc permit
rulesabylaws or and covenantstha mayhrehstracu`Lborprohibit such
),vhich is in con flictwith any applicable
structure. Please consult with your Horne Owners Association and review your deed for any restrictions which may appy.
in consideration of the granting of this requested permit, l do hereby agree that 1 will, in al§ respects, perforin 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,- 16ur failure to Record a Notice of Commencement may result in your paying twice for
improvements to yrs - ' property. A Notice of Commencement must be recon d and posted on the jobsite
before the first i, :` action. if you intend to obtain financing, consult witL der or an attorney before
commencirig v `rk r recording our Notice of Commencement.
of owner/ Lessee/Contractor as Agent for Owner
MIAN
g�.�
Thefor cling instru ant w s a knawledged efore'itie
this day of aAZ hY
`J !I\ t
Name of peakin statement
Persanall Known rso OR Produced identification
Type of Identification
Produced q`ee�6gggli9!°t3i��
•Gtj�ttMlSS/�'���%� s
(Signature of Notary Public -State of Fldfi a•')
Commission No. F� 1�-7SAB$
a.., e p pA ` � F�.+�.'�.. � A .;��;d�dtf r cx5•: •P
REVIEWS I FRONT ZONING Stj � RViSOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
CO 1Vi P LETE D
Rev. 8/2/ 17
of Contractor/License Holder
STAVE OF FLORID
COUNTY OF ( 2t, L I^- U,y
T heforgoing instrument w s acknowledged efore me
this d �dayof 2G by
Name of personking statement
Personall Know OR Produced Identification
Type of Identification
Produced
lS�te9,.,.. or/e1l
\e A RI k
(Signature of Notary Public -State o tor'
Commission No. FF—t95�°
SALE A L. BLiri_IK ,e�A�� r9.
PLANS VEGETATION SEA TURTLE A���
REVIEW REVIEW REVIEW _ I W