HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:` d 1 pl
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
PERMIT APPLICATION 1=0R: AI G P,-w- L. Ke�
PROPOSED IMPROVEMENT LOCATION:
Address: 6a i L- /l Y C 2. Cp, 3 W7 $�
Legal Description: � 1a_v\- Ife-V E ` -�Je.5 t k n ; Vb ck (_645 l Cp 0-VIA (7
Property Tax 1D #:('0L7)a Lot No. 16 --i
Site Plan Name: Block No_
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:. -_�
CONSTRUCTION INFORMATION:
Additional workto e e orme under perrn�t— c ec a p
HVAC Gas Tank ❑Gas Piping t5Shutters O
Windows/Doors
€ Electric Ll Plumbing Sprinklers 1� Generator ICE Roof C� Roof pitch
Total Sq. Ft of Construction: 5 . Ft, of First Floor:
Cost of Construction: $ of p . f Utilities: _Sewer ESeptic Building Height:
OWNER/ LESSEE:
CONTRACTOR:
Name Name: James Snyder
Address: Aje- s,e- It, Company: Snyder`s Cooling and Heating, Inc.
City: _721r (� j e�/c�2� State: fI . Address: P.D. Box 2007
Zip Code: Fax: City: Fort Pierce State: FL
Phone No. `i 2a r _75 - 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
from the Owner listed above) State or County License: CAC1816579 1#26414
if value of construction is $2500 or more, a RECORDED notice of Commencement is required.
GQf1�ST4UCTfOfV LfE[!I LA1l1i f�;��RMATIUN;
3�ESlC�I�iE�,/EN'�ilVlrER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
Zip: phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE FI�Li,�lw€t:
Name:
Not Applicable
��N®Ii11G COMPANY:
Name:
_Not Applicable
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, 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 yo property. A Notice of Commencement must be recorded and posted on the jobsite
before the first i ctio , you intend to obtain financing, consult with len r or an attorney before
commencin rk or cordin our Notice of Commencement.
Rev.8/2/17
SUPPLEMENTAL
� t of Owner/ Lessee/Contractor as Agent for Owner
i t of Contractor/License Molder
TE OF FLORID
CC)�NTY LDF l�t�`.-�—t �
TE OF FLORID
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The foing instryspent was acknowledged before me
this day of [�..-,�c5 �' , 2C 1 9 by
The forgoing instru ent was ackn wledged before me
this j� day of �. za f`l by
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Name of person aping statement
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Personally Known Produced identification
Personally Known OR Produced identification
Type or Identification
Type o'F Identification
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