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HomeMy WebLinkAboutLaflamme - 775 NE Prima Vista Blvd SLCALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:Al 3 { Permit Number: J _ Building Permit Application Plunning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fart Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: ki C" cl t PROPOSED IMPROVEMENT LOCATION: Address: 775 IQ[r— t' a. Legal Description: l 11 P Qu1fr t 7` l v (� Ljj7` Property Tax ID #: 1 5 _ Qtr 5-7 - © bn ' f Lot No. Site Plan Name: Block No. 4 S Project Name: Setbacks Front Back: Right Side: Left Side: [DETAILED DESCRIPTION OF WORK: A- ChoV) a- - LA K eP-0i)( U K e- amen 5n J 1 ��+r w; fl KL13 CONSTRUCTION INFORMATION: Additional wor to a orme un ert €s perm€t- e ec a t app y: �HVAC Gas Tank Gas Piping Shutters l_! Electric Plumbing F]5prinklers Windows/Doors E Generator Roof Roof pitch Total Sq. Ft of Construction: S ` FFtt.j of First Floor: d 2 Cost of Construction: $ O U Utilities: f _ Sewer Septic Building Height: OWNERAESSEE: CONTRACTOR: - Name r r} �[~ Name: ,fames Snyder Address: -7"7 N jr€ Lk (VA mr- 1 - Company: Snyder's Cooling and Heating, Inc. City_ Y (5-1-, State, • Address: P.O. Box 20137 Zip Code: 3L06A Fax: City: Fort Pierce State: FL Phone No. Z - 3 3 - Q i D� Zip Code: 34954 Fax: 772-6QD-4811 E-Mail: - Phone No. 772-528-3377 Fill in fee simple title Holder on next page ( if different E-Mail: snyderscooling@aoi.com from the Owner listed above) State or County License: CAC18165791 #26414 If Vail is of : elEnn -- -. -e -+ — F­jt=� tl [[CLfj ur-ll lvouce of uornmencement is required. SUPPLEMENTAL CONS T RUCTI LIEN LAW INFORMATION: DESIGNERIENGINEER: � Not Applicable MORTGAGE COMPANY: Not Applicable Name: I Name: Address: i Address: City: State, City: State: Zip: Phone I Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Applicable Name: _Not Name: Address: I Address: City: City: Zip. Phone: Zip: Phone: QVIJIM K/ 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 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 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 first J spec . If you intend to obtain financing, consult with lender or an attorney before commencin�orL- recording your Notice of Commencement. / , of owner/ Lessee/Contractor as Agent for owner ig of Contractor/License Holder STATE OF FLORIDA, / rS5TATE OF FLORI©��COUNTY ®F� � u OUNTY OF 11i le - The forgoing instrumgnt as acknowledged before me this day of oP,� 204 by r� Name of perso making st tement Personally Known ✓ OR Produced identification Type of Identification Produced 1111 (Signature of Notary Public- State of 1`14-a r fo'- a ' Commission Na.11//7 S a w, i i°iA L a B LA CK = 9OG 289862 Afndedtr$o. •��� REVIEWS FRONT ZONINC:,� COUNTER REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 The for Ding instr t as acknowledged before me this � day of en26A by Name of person making statemen Personally Known ✓ OR Produced identification Type of Identification Produced KIM Z. ature of Notary Public- State of y `V' £ommission ` " y SABRINA L. BLACK ;o to 2sss�Z PLANS VEGETATION SEATuw4z/� REVIEW REVIEW REVIEW "C ... 4fii1[t 11