HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�(_ Permit Number:
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Building Permit Appllication
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ���0�
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Commercial Residential
4- 1�
i� 0
. -1
Property Tax ID #: 1361 LP - . 1(o Lo - Cop - Lot No. -2-1
Site Plan Name: Block No. cPLa
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
A �tlonal work to e e orme un ert ispermit -c ec aii apply:
®HVAC Gas Tank Gas Piping _ Shutters Windows Doors
Electric 0 Plumbing Sprinklers n Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ Q o
Utilities: _Sewer Septic Building Height:
OWNER/;LESSEE:
Narne t ) e` ¢-kj J pl y
Address: 7 6 F.
City: &
State: PT
Zip Code: L oL Fax:
Phone No. T % G) I�
E-Mail: ---1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR;
Name: James Snyder
Company: Snyder's Cooling and Heating, Inc_
Address: P.O. Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Phone No. 772-528-3377
E-Mail: snyderscoding@aol_com
State or County License: CAC18165791926414
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL OONSTRUCII N LIEN LAIN INFORMA 1 ION:
DESIGNERJENGINEER: V Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: [Name:
Address: Address:
I City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR ,AFFIDVI T : Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no wort{ 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 aU 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 r pr perty. A Notice of Commencement must be recorded and posted on the jobsite
before the first ' spe . n. if you intend to obtain financing, consult With 1 der or an attorney before
commencing,,Kf'orl recording our Notice of Commencement.
of Owner/ Lessee/Contractor as Agent for Owner e of Contractor/License Holder
,ATE OF FLORID r STATE OF FLORI ff
COUNTY OF • t-U—� t_— COUNTY OF. I-, �--_
The fo Ding instr e t wa acknowledged before me
this day of Q� 20A by
ov
Name of perso aking statement
Personally Known OR Produced identification
Type of identification
Produced
(Signature of Notary Public- State of Florid W'
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Commission No`�5e; lQ d 1 101v`
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SABRI11iA L. BLACK E
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Rev, 81Z/17
The forgoing instr en was acknowledged before me
this CSC of Le D Q 20 IcIby
Name of person rr aking statement
Personally Known ✓ OR Produced identification
Type of identificatioFj
Produced
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(Signature of Notary Public- State of Florida) ������ .�• •.. —B
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.,Commission No.C)IJAMb2
SABRI N.A L. BLACK�-
LANS VEGETATION �SEATURTLE:%4'f s `0VIEW , REVIEW REVIEW 1f1FW':c�.Q