HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
1
Date: S 17 1 1 ,q 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
PERM IT_APPLICATION FOR: A-Ic-
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: La- le-(,-5Dbd— 'faw UAy 4--7 - � . $ y — L6 +
Property Tax I D #: D) (.2 D� . + f (� pvp . 7
Lot No_ I 3
Site Plan Name: Block No_ Eq
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF 11110RK:
A- I C_ C V)aw'SR� 6-L" f Lei 14ve- -C� b K--
CONSTRUCTION INFORMATION:
Additional wor to be e orme un ert is permit---c ec a t app y:
Fv-]HVAC Gas Tank Gas Piping _ Shutters
l�f Electric ❑ Plumbing OSprinklers iLI Generator
Total Sq. Ft of Construction:
Cost of Construction: $ J-7 1 Q , 00
S Ft. of First Floor: _
Utilities: —Sewer Septic
QWindows/Doors
ElRoof C� Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Q j it ti
Name: James Snyder
Address: -7$D� s &rt ���
Company: Snyders Cooling and Heating, —Inc.
City: �4-. ;QAC State:
Zip Code, 3 1-1 i 51 Fax:
Phone No. - 14b Lo - Z-1 D 3o
Address: P.O. 8ox2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Phone No. 772-528-3377
E-Mail: -~r—
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above) I
E-Mail: snyderscooling@aol.com
State or County License: CAC1816579 ! #26414
.. .......,�1.., -1. i. ul a nr-%- MUCV MUCKe OF LOrnmencement is requlrecl.
SUPPLEMENTAL CONSTRUCTION LIED LAIN INFORMATION:
DESIGN E /EfilG9NEER: Not Applicable
Name:
MORTGAGE COMPANY: _Not Applicable
Name:
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 holderto 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 TQ OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements tqAeur property. A Notice of Commencement must be recorded and posted on the jobsite
before the firs . pe n. If you intend to obtain financing, consult with lender or an attorney before
corn rnenci or recording your Notice of Commencement, o
of Owner/ Lessee/Contractor as Agent for Owner
ature of Contractor/License Holder
rOATE E FLORIDA
COUNTY OF � �c.t Q�
STATE OF FLORIDA j
. cal
COUNTY OF —
The forgoing instru ent was acknowledged before me
The' Ding €nstru nt was acknowledged before me
�
this day of 20-A by
this day of 26Ig by
Name of person making
rson
Dame of peaking statement
Personally Known ✓ OR Produced Identification
Personally Known �OR Produced Identification
Type of Identification
Type cif Identification
Produced
Produced
TRW A !. �e� ��f����,`,ri
11
0�Bl�� q %0/k����i
(Signature of Notary Public -State, Flpr u�y2``;A •.
{Signature of Notary Public -State ofrigd, , UARJ,
a,
r Gi4 w a` •
Commission No Se l 's
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Commission No. GAcca = * •. (Sealy.
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REVIEWS
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PLANS
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COUNTER
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REVIEW
REVIEW
REVIEW
DATE
j
RECEIVED
DATE
COMPLETED
iev. 8/2/17