HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:—
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Building Permit Application Ash%�90 ?9,,g
Planning and Development Services
Building and Code Regulation Division °�oF�Pgt
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential ✓ l
PERM ITAPPLICATION FOR: HIG ( ,� � 4yUKe, L
PRQPOSED 1fVIPROVE( _ENT LOCATfON
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Address: 55� ylr ►1)L1�/ �Q�IlG2� Gf S i'
Legal Description: ar -Fko i5hcr'o_6 iG ict_62__ -�W O tz'T ras
Property Tax ID#:_17)a.` 5-11A - 01 Dq "zzb " I Lot No. o
Site Plan Name: Block No..
Project Name:
Setbacks Front Back: Right Side: Left Side:
aDETAILED DESCRI,RTION OF WORK: I
CQNSTRUCTIQN J,N:r MATPN. '
Additional wor to be r)ertormed under tis permit—Check all that appy:
2HVAC Gas Tank ❑Gas PipingShutters a Windows/Doors
OGenerator
Electric Plumbing Sprinklers Roof Roof pitch
Total Sq. Ft of Construction. Sq.Ft.of First Floor:
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Cost of Construction:$ L4.5. Utilities: _Sewer OSeptic Building Height:
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;, „ ; COiTRACTOR
Name f� V' Name: James Snyder II
Addres t: t _� iJ I Company: Snydees Cooling and Heating,Inc.
City: 't'. A pff 4Ue State: F I• Address: P.O.Box 2007
Zip Code. :zL► Fax: City: Fort Pierce State:FL
Phone No. G110 Zip Code: 34954 Fax: 772-600-4811
E-Mail: -J� 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/#26414
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTI N LIEN LAW INFORMATION:
DESIGNERIENGINEER: Not Applicable MOR T GAGE COMPANY: _Not Applicable
Blame: Name:
Address: Address:
City State: City: State:
Zip: Phone Zip: Phone:
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C FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: 1ANot Applicable
Name: Name:
I Address: Address: I!
City: City:
Zip: Phone: Zip: Phone: it I
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 ur property.A Notice of Commencement must be recorded and posted on the jobsite
before the firs " S ion. If you intend to obtain financing, consult wit lender or an attorney before
commenci o or recordin your Notice of Commencement.
A, re of Owner/Lessee/Contractor as Agent for Owner ign . of Contractor/License Holder
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STAT`OELOgf�3�A ? r STATE OF FLORI (
COUN TY OF COUNTY OF 4._Ltic-r
The for ng instruAent was-acknowiedged before me T he fo ing instr ent was acknowledge{ fore me
this day of 20 by j this day ?0!qy
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Name of person making statement (Name of persor�rr`akingstatement
Personally Known �/ OR Produced Identification Personally Known ✓✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Siof'acitate of ?�gia� •IC�9Mdfj�s.!, ��i_I (Signature of rotary Public-State of Florid ".Y CDM •.
SA S- Ri
Commission No. WM)'-neal) ® ?N` yCommissiono -: 4,96Pit
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SABRI iA L. BL-ACK `�;oo `G'�,v SABRINA L. �LACIC �_�:
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REVIEWS FRONT Z01NI sTq•-�"'fl ]<`4t'Is �i� PLANS VEGETATION SEA TURTLE ''� C3R :
COUNTER REVIE //p�/ OFREVIEW REVIELN REVIEW
DATE
{ RECEIVED
DATE
COMPLETED
Rev.8/2/27
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