HomeMy WebLinkAboutBuilidng Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9 1'�'g E M � Permit Number:
YT
Building Permit Application
Planning and Development Services
Building sand Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: �� (tet KC___
PROPOSED IMPROVEMENT LOCATION:
Address:Q °
legal Description: ��oL' � �,Io� �a e�S (�1v1 i ea\ �PJ5
Property Tax Iia #; • ���� � I ®- bbd, 3 - obD - 3 Lot No. � 3
Site Plan Name: Block No. v E2
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
A itona wor to e e Orme un ert as perm at—c ec a at appy:
QHVAC n Gas Tank DGas Piping _Shutters Q Windows jDoors
1 1 Electric El Plumbing Sprinklers Generator 0 Roof Roof pitch
Total Sci_ Ft of Construction:
Cost of Construction: $
OWNER/LESSEE:
Name
Address: J�� O I o�, n y z i�,r✓ :
SQ. Ft. of First Floor:
Utilities: 0 Sewer [ Septic
City: Stater
Zip Code: Fax:
Phone No. I rJ t " u 16Z
E -Mail:
Fill in fee simple Title Holder can next page ( if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: James Snyder
!'nrrananv- Snyder`s Cooling and Keating, Inc_
4rlriracc P,O, Bax 2447
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Dhnna Nn_ 772-528-3377
E -Mail: snyderscoolinga@aol.com
State or County License: CACIS165791 #26414
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Nary
Add
City
Zip:
NGINECR:
Phone
FEE SIMPLE TITLE HOLDER:
Name:_
Address
City:^
Zip:
Phone:
t AppVicable MORTGAGE COMPANY: .. of Applicable
Name:
Address:
State: City: State:
Zip: Phone:
V Not Applicable
BONDING COMPANY: ''Not Applicable
Name:_
Address:
City:_
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 the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and 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, 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: Your failure to Record a ratite of Commencement may result in your paying twice for
improvements to your pro A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. ytou intend to obtain financing, consult with 1 r or an attorney be;are
commencing work. r . rdin �rour Notice of Commencement.
Owner/ Lessee/Contractor as Agent for Owner
ATE OF FLORIDA
UNT`. OF
The f g instrument wa acknowledge b fore me
this ay of C �, Y
Name of person making statement
Personally Known � OR Produced Identification
Type of Identification
Produced
_1 2—�2
(sig9A19 TKNX1'YkbAekto of F
!"
commission No. r`, I g63b7
REVIEWS I FRONT I ZON
COUNTER I REVI
W+
DATE
COVIPLITEa
Rev.,S/Z/ 7
NA L, !y/
°n�Qi1
re of contractor/License Holder
STATE OF FLORIDA
COUNTY OF `
1 he forgoing instrument was acknowledged before me
this day of 20 L2 by
Name of person aking statement
Personally Known oR Produced identification
Type of Identification
Produced
{Signature of Notary Public- State of Florida
Commission No. P'r R671307
#FF 195337
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PLANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW RNA.