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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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 PERMIT APPLICATION FOR: Ak' C'h PROPOSED IMPROVEMENT LOCATION: , Address: i 9 f' �ka � Dili" yn0 ShDi�e�S � Z30 i�hdi Legal Description: 1-3 1;2— " 5D 1 - Obb 1 - CQCr-L Property Tax ID #: la y nQ �s�re__5 s 11L Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: 4AC, byw4_ oL J U L !� � CONSTRUCTION INFORMATION: Ad ditionalwo rk to be Dertorme-d under this permit— check all tbal apply: ®HVAC 0 Gas Tank DGas Piping _ Shutters a Windows/Doors F= Electric ❑ Plumbing 6 OSprinklers 11 Generator F Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: 9 S Ft. of First Floor: _ Utilities:i Sewer 0 Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name oy d ii�A i,26 OO Na e: James snycier Address�P �' 1✓ USG �J� A)• t4o b 44 1 aWny: Snyder's Cooling and Heating, Inc. City: Sir � 5y State: Zip Code: 9 335 I Fax: Phone No. _720 ..-q 1,00 v 1 [¢ © 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: snyderscooling@aol.com State or County License: CAC18165791 #26414 If value of construction is.2500 or more, a RECORDED Notice of Commencement is requtrea. SUPPLEMENTAL CONSTRUCTION LIEN LAM MFORMATION: DESIGNERJENGINEER: cab Not Applile 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: j Address: City: j 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 structure. Please consult ithwith any pyourHle Home ome Owners Association and revwners Association iew your deed or any restrictions waws or and covenants that: hich ch mayrestrict apply. prohibit habit such Y In consideration of the granting of this requested permit, l 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 ur property. A Notice of Commencement must be recorded and posted on the jobsite before the firs section. if you intend to obtain financing, consult with lender or an attorney before comrnenci or recording our Notice of Commencement. Of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORiD COUNTY OF The forgoing instrument was acknowledged before me this If day of_�20 l by �W, �S Name of person making statement Personally Known '✓ OR Produced Identification Type of Identification Produced �_ "_3 "" (Signature of Notary Public-S Commission No.CG _4V REVIEWS FRONT COUNTER DATE RECEIVED DATE COMPLETED Rev.8/2/17 re of Contractor/License Holder STATE OF FL.ORIDk f COUNTY t3F l 2r • L-- c"r 2_ _ The for oing instrument was acknowledged before me this 1 � day of C 7-0 M by t.�-t7 A.&.l— Dame of pets making statement Personally Known OR Produced Identification Type of Identification Produced .. Flo � !�?Y�(Signature of Notary Public- State of FJida •��issiok' c��Vx G p AR AR (� •. (5e jv�?per *' Commission No.&a.���r'a d ': ( l)Y�?4�.• Z yGfd 289&62 :: ' y 239882 g.o ' �' �d'S-'ion t•? .gym'':-p� � � O • �i tic nde p \� f p %A�ntledlht��s��°.Q�� ZO�1 ,pX8��1*5OR I PLANS VEGETATION SEA TL�L'i •:;A� RFVI (�/I!;JJ i:ttR ' EW REVIEW REVIEW REVIEVi /;;k,11