HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: " d i'l d I q Permit Number:
60 j
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential l�
PERMIT APPLICATION FOR: 1.
41 C_ 9 rPDV_L Ke_� Q
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: I A — Ob5-7— 0(s)n—Lo
Site Plan Name:
Proiect Name:
Setbacks Front Back: Right Side: Left Side:
}} w l seeAj
~ i l �-
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work toe pertormed un er t his permit — check a t t appy:
HVAC1:1 Gas Tank 0Gas Piping _ Shutters [Windows/Doors
�I Electric El Plumbing Sprinklers Generator U Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ �tll-71j4l
5. Ft. of First Floor:
Utilities: Sewer0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name zn . Pi kyr &rte
Name: James Snyder
Addressrr to 10 Y rrc,-&e--
Company: Snyder's Cooling and Heating, Inc_
City: I��'V it�fl` ilrc: 2� StateF
Zip Coder 5 Fax:
Phone No. ti � - ` La CQ -
Address: P.O. Box 2667
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-608-4811
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: snyderscooling@aol.com
State or County License: CAC1816579 I #26414
If value of construction is $2500 or more, a RECORDER Notice of Commencement is required.
S
UPPLEMENTAL CONSTRUCTION LIEN LAW INFORMA71 ION:
Z Not Applicable IVIORTGAGE CC3MPANY: "ot Applicable Name:
Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY- � of 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 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, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The foilowing 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 perty. A Notice of Commencement must be recorded and posted on the jobsite
before the first ins Ion.din ou intend to obtain financing, consult with lender or an attorney before
commencing w r r our Notice of Commencement.
/ Lessee/Contractor as Agent for Owner
SOF FLORID V
�vt—(�I
NTY OF
The forgoing instru t was acknowledged before me
this day of rrrr/i.." 20 -Al by
Name��s�onakingsment J11111111////
Personally Known OR Produced id,Type of Identification `��1
Produced If2
of Contractor/License Holder
SATE OF FLORIDA
COUNTY OF A'
The for ping instru pent was acknowledged before me
this day of 0 ' by
Name of person along sate— men't
Personally Known Ofd Produced identification
Type of Identification
Produced-
SAO
roduced
S
(Signature of Notary Public- State of r i & tire' '.' c� (Signature of Notary Public- State of Flori
r� o 0 8 d rc �' �p'.•
Commission No. l5 6o? g -i 0 � /
pry,.p cBLIC,Gir-
Commission No.
,//��.......[� � - ±Sat) �� `�, •;
lli 0,,``h\
i :L. •�'
'V fln
'moi • `•?c Undasvg•`-
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLL�i�i IN ,a te:
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW��\'►\�
DATE
I RECEIVED
DATE
COMPLETED
Rev. 8/2/17