HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. 3 1 `1 Permit Number:
Building Permit Application
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: 4C Lei n
PROPOSED IMPROVEMENT LOCATION:
Address: Soo 13gArnOc-c-GGi,k] 6+
Legal Description: i Ictf PALM �✓G�ti S j3Lk, �2 Co -r 12 --
Property `Fax ID ##: 3403 _ CD2 � 602-4- 0 00 Lot No. 1.2—
Site Plan Name: Block No. �2-
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I
C -:,00d, -n acn v? 400
Additional work tob[eDertormed under this permit — checKallt apply:
HVAC I] Gas Tank ElGas Piping _ Shutters a Windows/Doors
Electric El Plumbing 05prinkiers Lel Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $> SR4. Utilities.OSeptic Building Height:
OWNERAESSEE:
CONTRACTOR:
Nama—'2WQ.Y 00-41 C420_(&LY0'C- UIC,
Name: James Snyder
Address: i21-39 A'I r] 4Zd2 01
Company: Snyder's Cooling and Heating, Inc.
City: rwaxm e ki Stater_
Zip Code: Fax:
Phone No �O I�'��1$ "�Sti� _ _
Address: P•Q• 8ox 2007
City: Fort Pierce State: FL
Zip Code: 34� Fax: 772-600-4811
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: CACI 8165791 #26414
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:✓Nat Applicable MORTGAGE COMPANY: ✓ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 installation has commenced prior to the issuance of a permit.
St. Lucie Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which
structure. conflict
lease consult any
Owners Home Assn Association and review your deed ws or or any restntss restrictions s which may oapply.
prohibit Mbit such
Y Pp Y -
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 following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, wails, 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 ypur property. A Notice of Commencement must be recorded and posted on the jobsite
before the first pec, . n. If you intend to obtain financing, consult with der an attorney before
commencing~ rk ecording your Notice of Commencement.
Sig "vner/ Lessee/Contractor as Agentfor Owner
T FLORIDA
NTYrOr
9 .--►A_
The forgoing instrum nt was cknowledged before me
this day of 2011 by
Name of perso aking state nt
Personally Known i OR Produced Identification
Type of Identification
Produced
Contractor/License Holder
E OF FLORID
NTY OF . LIA_ (1
''`
The f Ding instrurp� t�ac nowledged before me
this day of ff �Y 44 2p { %y f
Name of perso aking state ent
Personally Known v OR Produced Identification
Type of identification
Produced
Ifl! cz�.%L.•,_ ��- _ r ,�t, �l�I
EZ5 L• B �/� Si nature of Nota Punlic-
(Signature e of FlSjda . pof Notary Public -State of Floricp0....,�qii gf`�f3$�I�9 l3 �w ssi SFaBRlNA Commission No. tT t5+ ,ommission Nl] �s3
l a•, or
ed th
REFRONT
Vii' �. ',.�d/1 e t��e•••�
PLANS VEGETATION SEA7URTL
VIEWS 1 RONT ZONII�j p�A.��R>=VIEW REVIEW REVIEW
COUNTER REVIE Iii.. �i ;'•`�°.�`�
RECEIVED
DATE
COMPLETED
Rev.3/2/37