HomeMy WebLinkAboutWaxberg - 1836 Bar Harbor Drive FPALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: D l d 1-1 Permit Number:
t
0LS
Building Permit Application
Planning and Development Services u
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: . A - I (, 6r-J
PROPOSED IMPROVEMENT LOCATION:
Address: 3LO `i'7G lour c�ir 4�4• 490 e'q--c.e_ll ^�� f
Legal Description, 3 v35 J-1 A104g . Le,ss aubn ma_wt-r "lam i'S I C�A a,.J— l ASS 15-6 f
Pave mr ,v<-_f,,r.:,4- 10:nDL le,5s c,,�,& a- gt) 6jw 0 1e55 1-95 3
Property Tax ID #: 31)3 'oZi I - 0-0c) S Lot No.
Site Plan Name: Block No.
ProjectName:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Bch ��' U - a
z)AJY\a,, cq- �5 4--, he-JW
CONSTRUCTION INFORMATION:
itiona wo to je�ej orme un er# ispermril eck all that apply:
ZHVAC L �I Gas Tank Gas Piping _ Shutters Windows/Doors
FlElectric ❑ Plumbing Sprinklers 1� Generator Roof Roof pitch
Total Sq. Ft of Construction:
!� O
Cast of construction: $ 6) m)
S Ft. of First Floor:
Utilities: OSeptic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name l�Yvi n tab
Name: James Snyder
Address: I 0pBl p ps( p.a(b f ,
Company: Snyder's Cooling and Heating, Inc.
City: i L'V' C.-e1 State: F71
Zip Code: aggqS Fax: a
Phone No. `7�� cj �� C) o7,Z-
Address: P.0- Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Phone No_ 772-528-33T7
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: CA01816579 / 426414
.�.�� .... 1....,.,�. ��q�Wu ul eflu[ C, d nr_c.LJrcueu ivvuce or LOmmencemenr is required.
SUPPLEMENTAL CONSTRUCTiQN LIEN LAW INFORMATION:
OESIGNE
Name:T
Address.,
City:
Zip:
EER- Not Applicable I MORTGAGE COMPANY: ✓ot Applicable
Name:
Phone
State:
FEE SIMPLE TITLE BOLDER.: " Nat Applicable
Name;_
Address:
City:
Zip:
Phone:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: ✓ Not Applicable
Name-_
Address:
City: M
Zip:
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 Counter 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, 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 property_ A Notice of Commencement must be recorded and posted on the jobsite
before the first ion. If you intend to obtain financing, consult with lender or an attorney before
commencin or r recordin our Notice of Commencement.
I
I
g re of Owner/ Lessee/Contractor as Agent for Owner
a€ Contractor/License Holder
STATE OF FLOIII3
STATE OF FLORIDA
COUNTY OF F
COUN I Y OF
The forgoing instrument was acknowledged before me
Ws day of [9 by
The forgoing instru nt was acknowledged before me
this �_—day of 20'1 by
Name of person aking sta ement
�OR
Name of person along statement
_OR
Personally Known Produced Identification
Personally Known Produced Identification
Type of Identification
Type 01 Identification
Produced
-L-- � J
Produced
SAB l��i
\\'>`!��►111i1111111�1� /'i,
f of P State of Foda )..••••••• ���y�
� � �• `:�
{Signa u of Notary. Public -State of Flo�j;'' '�Py
St/ ��f2INA L. BLACK
ea�G�RU�p�••';��
Commission No. % gg�lp�— 1 y�
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Commission N0.Ga=n1?Loam
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REVIEWS
FRONT
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PLANS
VEGETATION
SEATURTLE
COUNTER
REV1 yrcS
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REVIEW
REVIEW
REVIEW
DATE
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1i111{I!l►11
RECEIVED
DATE
COMPLETED
Rev. 8/2/17