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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I S j Permit Number: Building Permi pplicativn I'©� _7/1SJ)`9 Planning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 1� Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMlT APPLICATION FOR: OL,4 (� � e PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: P(--4::a Property Tax I #: 6o l — DDLI - (565 - 6 (� C� Lot Na. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional work to be orme un ert is permit -check alFt-F atapply: �HVAC J_I Gas Tank Gas Piping _ Shatters Windows/boors Electric Plumbing O5prinklers [�_] Generator El Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �j�Q -� Utilities: 11_ Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name rP_ q DY L-tf i5 Name:.farnesSnyder Address: �j 3 a_ wri T}_ � Company: Snyder's Cooling and Heating, Inc_ City: z v Cc - S e: �(, Zip Code:, 152p �Lll q �5 d Fax: Address: P.O. Box 2007 City: Fort Fierce State: FL Phone No. "2-2 �2 -7 Zip Code: 34954 Fax: 772-600-4811 E-Mail: phone No. 772-528-3377 Fill in fee simple Title Holder on next page ( if different E-Mail: snyderscooling@aol.com State or County License: CAG1816579 ! #26414 from the Owner listed above) 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 Name: MORTGAGE COMPANY: Not Applicable Name: I Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE MOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable 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 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 your property. A Notice of Commencement must be recorded and posted on the jobsite before the fast inspection. If you intend to obtain financing, consult with lender or an attorney before commen0hR work or recording your Notice of Commencement. Joure of Owner/ Lessee/Contractor as Agent for Owner of Contractor/License Holder STATE Or FLO tI ��c/i TATE OF FLORIDA " COUNTY OF . 2� COUNTY OFL-51., E The far Ding instru ent was acknowledged before me this day of , 2Q� by The forgoing instr nt was acknowied,d before me l this day of J 20T fey Name of person r�saking statement Name of person m�ftg stat me ent Personally Known 1� OR Produced Identification Personally Known V OR Produced ldentiFication Type of Identification Type A Identification Produced Produced �ti1111111flflfi�i, i� 'I t `\``��� _ Mr 't B� "". (Sigrture of Nafy Public -State of Frati s� e � .�g� • .� � Commission No. ���g Signature of Notary Public- Stat j S SABRINA L. BLACK : S ; gmmission No. S +- REVIEWS FRONT ZONING�///F� PLANS VEGETATION51ATU�W,�VE � 1 COUNTER REVIEW REVIEW REVIEW REVIE1hl�ffff DATE RECEIVED DATE COMPLETED Rev. 8/2/17