HomeMy WebLinkAboutBuilding Permit Application 16-Aug-2019 16:34 Fax 17726004811 p.3
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )
Date: Permit Number: l 0 08S y
Building Permit Application
Planning and Developmentservices
Building and Code Regulation Division
2300 Virginio Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential V
PERMIT APPLICATION FOR:41( Ok
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Address: J�J��o� i rl L �'Y e ,t l�, F�• Yt QNG2 , F{. 31�a��
Legal Description:-�iouA--. Q Ut-V E6 7'AfLS Lby's
Property Tax ID#:,34Da • CJ DA - oA8,3 -ODD-? Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_. Back: Right Side: Left Side:
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Additionalwor to e e orme under tispermtt-c ec a appy:
QHVAC rl Gas Tank Gas Piping _Shutters (�Windows Door
11Electric ❑Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Constructionn:1S Ft.of First Floor:
Cost of Construction:$ 6 Li 0. �� Utllitles:i Sewer O Septic Building Height:
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Name Name:James Snyder
Address: Company:Snyder's Cooling and Heating, Inc.
City: L 1Pi f,rL,f _State: 'Fl. Address: P.O.Box 2007
Zip Code: Sq C?g 1p- Fax: City, Fort Pierce State:FL
Phone No. -7'70; - 14-726 g 3 49 Zip Code: 34964 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 l#26414
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
16-Aug-2019 16:34 Fax 17726004811 p.4
SUPPLEMENTAL.CONSTRUCTi ; LIEN LAW INFORMATION: l
DESIGNERIENGINEER: �Not Applicable MORTGAGE COMPANY: ✓iClot Applicable
Name: Name:
Address: Address:
City: ..... State: City: State:
Zip: PhonI Zip: Phone:
FEE SIMPLE TITLE HOLDER- _Not Applicable BONDING COMPANY: ^Not Applicable !
Name: 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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws oran 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,walis,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 yaur paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inpection. If you intend to obtain financing,consult with lender or an attorney before
commencingk or_i;ecording your Notice of Commencement.
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I t of Owner/Lessee/Contractor as Agent for Owner f of Contractor/License Holder
ATE OF FLOR 1 / ATE OF FLORIDA /
COUNTY OF Lj /�.��-Li R� COUNTY OF �� • L,-A-e-4 t�
jThe forgoing instrugpent was acknowledged before me The f ing instrurpVnt was acknowledged before me
1 this day of G 20��by I this day of <' 20 by
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Name of pers malcirrg sta ement Name of person aking statem nt
Personally Known � OR Produced Identification Personally Known �OR Produced identification
Type of Identification Type 0 Identification
Produced Produced
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(Signature of Notary Public-State of Fll das� ao tignature of Notary Public State of Florida)'S •""'•�C i
1 Commission NoG Ad q D Pd- Mail �GG2ssss2 �Ernmission Nob ����Dc� (Se,'a�4�� ��C=
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REVIEWS, FRONT I ZONING /F � l� PLANS VEGETATION SEATURTL> Od6d§ o
COUNTER 1 REVIEW R W REVIEW REVIEW REVIEW
DATE 1 I HtltilH
RECEIVED I
DATE i
COMPLETED
Rev.8/2/17