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HomeMy WebLinkAboutKeaton - 1207 Parkland Blvd. SLCALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -1 [`3D C I C, Permit Number: Building Permit Application Planning and Development Services Building and Code Reguiation Division 2300 Virginia Avenue Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: AG PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: 1Kvex'JaA RCk-t " f eb h"��-5 -�' L� � � C.k_ c7 L0 -E Q_,�d_ oLj) L•p 4"S Property Tax ID#: 341CDq -7D,3 "01N7-DOD -J - Lot No. S Site Plan Name: Block No. �3 Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: ILQ CONSTRUCTION INFORMATION: ACIditional work to jee orme un ert ispermit—c ec a appy: RHVAC L_{ Gas Tank Gas Piping Shutters a Windows/Doors 11 Electric ❑ Plumbing 05prinklers Generator E]Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ Sq. Ft. of First Floor: _ Utilities:Sewer ❑Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: James Snyder Address: l aD rl-.r 14,1 d�LU Company: Snyder's Cooling and Heating, Inc. City: + i Lg c.t✓ State: Zip Code: '&L Fax: Phone No. --?A -_c2D [ - 1 D D `J Address: P-0- 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) rs.. I. _.0 _ _ A--- E-Mail: snyderscooling@aol.corn State or County License: CA01816579 / ##26414 ----- _. ..«........., y�..vv vs a V,C, 0 nzt-w YIJrU IVU{I6:e Ui Lammencement is requires. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESiGNERIENGINEER: Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Dame: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: 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 1 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: Vow failure is Record a Notice of Commencement may result iDyour paying twice for improvements to your ope y. A Notice of Commencement must he recorde d posted on the jobsite before the first ins do you 'intend to obtain financing, consult with le er oy�an attorney before commencing w or cording your Notice of Commencement. Owner/ Lessee/Contractor as Agent for:;OThe actor/License Holder r FLO f ) L1u I®F Lb- c�, Fforgoing v+ The forgoing instrume was acknowledged before this 9 day of J 24jJ by um t was acknowledged beforeme this a0day of 2Q by Name of perso making statement Dame of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of identification Type dF Identification Produced Produced �� �i � J {�1111 !►lllrt/Ii! f5igna ure of Notary Public -State of Florid. 5�,,,,, �. 8 //i //� rr�J q • va o2�A.� {Signature of Notary Public- State of Florido"� .• Mfd1 •., `4' F� BAltq� ���ss CornmissionNo. � O�P eatjetoU C ;&A 4 �� �� '�yysrnrnissianNo6ea'btg�a. �5e�1} ���`q•. REVIEWS i FRONT ZONIilk A • � ''�. MNS A VEGETATION SEA TUR7L��� COUNTER REVIEI/ Z ���REVIFW REVIEW REVIEW DATE ! f�f/11111Hh1t���� 11f11iii11 � RECEIVED {SATE COMPLETED Rev. 8/2/17