HomeMy WebLinkAboutGutierrez - 4949 A1A #141ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5113 11g Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772) 452-1553 Fax: (772) 462-1578 Commercial Residentialy
PERMIT APPLICATION FOR: A� C Y b 4 Er]
PROPOSED IMPROVEMENT LOCATION:
Address: 4`719 N. _4�,
Legal Description:
Property Tax ID ##: 4 I c) C>U i - Lot No._
Site Plan Name: Block No_
Proiect Name:
Setbacks Front Back: bight Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Additional work to be i3ertormed under this permit — check all tnal apply:
ZHVAC LJ Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
Electric Plumbing 05prinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 3<2,P'd ` Utilities: _ Sewer Eheptic Building Height:
OWNER/LESSEE
CONTRACTOR:
Name C45 i Pit! Y- -O-
Name: James Snyder
Address: L+�t LICI tJ. A l A 4-- ).q I
Company: Snyder's Cooling and Heating, Inc.
City: ay -A- 1f' 7 &,V-CJL _State:
Zip Code: a C} ot�A fr 7_ Fax:
Phone No. �s`� -- Z� l� -�o��Q
Address: P.O. Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 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: snydemcooling@aol.com
State or County License: CAC18165791 #26414
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTI N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: � Not 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.
1 certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count 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 Horne 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 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�-P'
ope . A Notice of Commencement must be recorded and posted on the jobsite
before the first insn youIntend to obtain financing, consult with der or an attorney before
pcommencing wo r rrding your Notice of Commencement.
Lessee/Contractor as Agent for Owner
'E OF FLORID
NTY OF (`, . -�- •�
The forgoing instrument was acknowledged before me
this day of 20�L by
Name of person�r king statement
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
of Contractor/License Holder
>11
STATE OF FLORIDA r
COUNTY OF
The for ing . strurunt was acknowledged before me
this day of
26 by
Named o per on king statement
Personally Known
OR Produced Identification
Type of ldentification
Produced
l>tlltllrlratr//� Qom' RiN,q���i�.
!;(Signa u t of�lori '1' • L'
(Signature of Notary Public -State 0fbrid3I+RY�Q�; ,�cG6r�•.�
SABRINA L. BLACK
� * ag
eal) Commission Na ��� ea�� o (SeaQ.Commission No.�4 •�
. n ROG Z89862 • d �, s2
Eder;.•' Q
REVIEWS FRONT ZOiVlhi'..�� Nt
PLANS 7EGTATION SEA
COUNTER REVIEW JJ fill � REVIEW IEW REViE �JJII! Ott!
RECEIVED
DATE
COWiPLETED
Rev. 8/2/ 17