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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE 1 FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / Date:_ 1� � ! Permit 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).462-1578 Commercial Residential PERMIT APPLICATION FOR:AIC, ,( ( � � a PRdI?QSED i'NCPROV-E, T„Lt ;CATlO1Vt x , ' k ya. Address: -M7 ,-- ra"bf f 6 L 5419 -6 Legal Legal Description: Property Tax ID#: 3,94 - �SrD A ” DO `l - Lot No. -70 Site Plan Name: Block No. Project Name: Setbacks Front Back: (tight Side: Left Side: 'CO.NSTRUCTIO,N�INFORMA°TCON� � ;_ "} r �� r Additional worto foe peOrmuneris permit—c ec a app y: -QHYAC Gas Piping u rWindows/Doors Gas Tank a Electric. F-1 Plumbing Sprinklers Generator F]Roof Roof pitch Total Sq.Ft of Construction: Scl. Ft.of First Floor: CJ Cost of Construction:$ q L16• Utilities: Sewer!Aseptic Building Height: Name U� rL Name: James Snyder Address 7 7 SaAcQ e cook_ . Y, Company: Snyder's Cooling and Heating,Inc. City: 6L. State:; Address: P.O.Box 2007 Zip Code; �a` �' Fax: City. Fort PierceState,FL Phone No. '7'?A -"7V 8 `7 Zip Code:34954 Fax: 772-600-4871 E-Mail: `—"~� Phone No.772-528-3377 Fill in fee simple Title Holder on next page(if different E-Mail: snyderscooling@aol.com from the Owner listed above) State or County License: CACI 8165791#26414 If value of construction is$2504 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTI „ LIEN LAW INFORMATION: DESIGNER/ENGINEER: Nat Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: Cit State: City: State: city: Zip: Phone Z Zip: Phone: FEE SIMPLE TITLE HOLDER: �Not Applicable BONDING COMPANY: ,,,_Not Applicable Name: 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 installatiombas commenced prior to the issuance of a permit. St.Lucie County snakes 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 Assoclation 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,l do hereby agree that 1 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 OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your roperty.A Notice of Commencement must be recorded and pasted an the jobsite before the first ins i . if you intend to obtain financing,consult with lender or an attorney before commencin w oo:Pi our Notice of Commencement. Si f Owner/Lessee/Contractor as Agent for Owner of Contractor/License Holder !` METE C7/F FLC}Rll? - A1TpE��O��F�yFLORI©A ,,/\ � ` T Ol' r (�-(A � COUNTY ld t 7 V F "��e The forgoing instrument was acknowledged before me The forgoinginstru t was acknowledged before me this day of A u-u.c,;�l za11by this_,L,day of��Y�-c� p...-Ijr by � - Name.oferson kin estate lent Name of person king state ent Personally Known. V OR Produced Identification Personally Known wOR Produced Identification - Type of Identification Type d1f identification Produced Produced .a.iltrruEni�i _ � ellAllytRpt�r//r � t� ASRI�/q�/fi,�� (Signature-of Notary Public,Sta er (ofl• b<aary2 Ff'• ignature.of Notary Public State of;Flta SABRINA `'��: SABRINAj � � '-Z �,c�9•� mr Commission NoMh3Es l 'p Commission No� 7 �h/�St TEOF�'����� �rtrlllgN4�ti REVIEWS FRONT ZONINr;jJ11rr ri�tUISOR PLANS VEGETATION 'SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17