HomeMy WebLinkAboutBuilding Permit ApplicaitonSUPPLEMENTAL CONSTRU. T LIEN LAME INFORMATION:
DESIGNER/ENGINEER: v Not Applicable
Name:
MORTGAGE COMPANY: Riot Applicable
Name:
Address:
Address:
City: State:
Zip: phone
City: State:
Zip: Prone:
FEE SIMPLE TITLE HOLDER- Not Applicable
Name:
BONDING COMPANY: Riot Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
i
Zip: Phone:
OWNER/ C:)NTRACTOR 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
lNARNtiAiG TO OWN ,JER: Your failure to Record a Notice of Commencement may result in your paying €wice for
improvements to our property. A Notice of Commencement must be recorded and posted on the jobsite
before the firs nspe 'on. if you intend to obtain financing, consult wit ender9r an attorney before
commencin or recording your Notice of Commencement.
ner/ Lessee/Contractor as Agent for Owner
eATEOF
e of Contractor/License Holder
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TATE OF FLORIDA
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The fgrgDing instr�was acknowledge efore me
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The f oing instru nt was acknowledged before me
this day of Zfl�by
this-lLdayof 1A, 2019 by
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Name of perso malting statement
Name of person aking statement
Personally Known l7 OR Produced Identification
Personally Known OR Produced identification
Type of Identification
Type of identification
Produced
Produced
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j (Signature of Notary Public -State of Florida) * •� f�OR� Rr�•
(Signature of No -Lary Public- State of - -I a. 10A, % i
Commission No.(. C)(M ! �� a * 2�t�{ s} v'•:
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Commission No. � � � O l 100� (5 � •�
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DATE
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RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ALL APPLICjABLEt INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: <1 11 C1 Permit Number:
,J
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34.982
Phone, (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Ai UQtqnl��
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PROPOSED IMPROVEMENT LOCATION:
Address: �] a n p �-L bJ
Legal Description:
Property Tax iD #: i � _ 5D I — V7 01 - OOD - 9
Lot No.
Site Plan (Name: Block No -
Project Name:
Setbacks Front Back: Right Side: Left Side:
L.DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
A itiona war to e e orme un er t is permit — C eckallth apply:
ZHVAC Gas Tank Gas Piping_ Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
2 [5D
Cost of Construction: $ LI-7J � • — Utilities: n Sewer Septic Building Height:
OWNER LESSEE:
CONTRACTOR:
Name
[Name: James Snyder
Addr7a�5�����ate:
Company: Snyder's Cooling and Heating, [nc.
City: Ertl .
Zip Code: s3y 61 5A Fax:
Phone INo. 4 - 6) -7 - 5d,3)
Address: P.O. Box 2007
City: Fort Pierce State: FL
zip Code: 34954 Fax: 772-600-4811
Phone No. 772-528-3377
E-Mail:
Fill in flee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: snyderscoo[ing@ao[.com
State or County License: CAC18165791 #26414
���uulsiult:, d nr-,-urcvev ,uotue or commencement is requires.