HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: U d 13 l I R Permit Number:
KN C(t. R..
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 r/
PERM IT_APPLICATION FOR: ��� �- r � G K
PROPOSED IMPROVEMENT LOC TION:
Address:
Legal Description: La-Ke— L,--�C ocl Dc-y�-(�t�/Lc I IL ]Lp
Property Tax ID ##: _ ._ r? ' U 1 3 - Ou 0 7...- dbb - .2 Lot No. 1 �
Site Plan Name: Block No. 5C(
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be nertormed under is —check allt apply:
ZHVAC Gas Tank Gas Piping _Shutters aWindows/Doors
QElectric 0 Plumbing Sprinklers Generator Roof Root pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
J� �
Cost of Construction: $ Z1 � q 6 Utilities: _ Sewer OSeptic Building Height:
OWNER/LESSEE,
CONTRACTOR:
Name '� e:
Name: James Snyder
``[A—)-
Address:-U 6D1 pz5c�., AtWq
Company: Snyder'sCooling and Heating, Inc_
City: �-� . c.� State: _�.
Zip Code:- !< Fax:
Phone No. —7a — 44 Lo4 -7-7
Address: F•p• 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: CAC 18165791 #26414
1k vague or consirucuon rs .�,c5uu or more. a KtLUKULO Notice of Commencement is required.
Fam
EMENTAL CONSTRUCT19 LIEN LAW INFORMATION:
ERIENGIN1lEER: Not Applicable MORTGAGE COMPANY: ✓Not Applicable
Name:
: Address:
City:State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: / Not Applicable BONDING COMPANY: �ot Applicable
Name: blame:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNED/ 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 structure. Pleasecconith sult withpypour Hlome Owners Association aondrreview your deed aws Oranor any restrictions covenants that which maor
aprohibit such
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 Piorida auMing 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 thrice for
improvements to your property. A Notice of Commencement must be recor nd posted on the jobsite
before the first in ec ' If you intend to obtain financing, consult wit n ran attorney before
?STATE
rk recordin our Notice of Commencement.
wner/ Lessee/Contractor as Agent for Owner ure of Contractor%License holder
LOR� STATE OF FLORIDA J L C�C� COUNTY OF �
The fQr wing instruruent was acknowledged before me
this !dayof . 120 by
J ,n �✓
Name of pers aking stat ment
Personally Known OR Produced Identification
Type of Identification
The forgoing instrpxiaeRt was acknowledged before me
this _La day of _ (_J 20� by
Narne of perso -making statement
Personally Known OR Produced Identification.
Type of Identification
Produced
L.
{Signature of Notary Public -State of P�ida`����� (Signature of Notary Public- State of PJa j•.yOyif '
o��tss10/v .�'� > SABRIINA i_. Bl_AC � �A e� ?
�1�� -mac, pUARYo •. y
Co�S3bh°i�iC7.L 'LAGioC Commission No. ea o�
o : p #Gczssa6
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REVIEWS FRONT ZY '-1 •°
COUNTER REVI;��lit
RECEIVED
DATE
COMPLETED
Rev.F/2/17
PLANS I VEGETATION I SEA TURT
REVIEW I REVIEW REVIEW