HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1,2 q Permit Number:
._
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort pierce FL 34982
Phone: (772) 462-1553 Pax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: bwe_
PROPOSED IMPROVEMENT.LOCATION:
Address:
Leg�
Legal Description: h. tQ � . a a f�
Property Tax ID #: D Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
A I c cl L�G t)j M 10
/ J
CONSTRUCTION INFORMATION:
Aaditional work to be
' be orme u�ert
ec a apP Y:®HVAC IJ Gas Tank Shutters �F] Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 0 goof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ J O S , � lltilities:cn Sewer aSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR;
Name Q.Q1 �Vl�
Name: James Snyder
Address: �a2 r,
Company: Snyder's Cooling and Heating, Inc -
City. P-I State:
Zip Code: ��%�Z Fax:
Phone No. Y . L—1 L� W
Address: P-O. Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-481 1
Phone No 772-528-3377
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
...---
E-Mail: snyderscooiing@aol.com
State or County License: CAC1816579 / #26414
- -- ----- , ,..... ... c, a n". %jr%Ucv Ivuufe ur Lammencement is requires.
Co n$ iRA W64V L. I k- A r K
REVIEWS � FRONT
COUNTER
DATE
RECEIVE
COMPLETED
Rev. 8/2/17
SUPPLEMENTAL CONSTRUCTPN LIED LAW INFORMATION:
DESIGNERIENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Nat Applicable BONDING COMPANY: of Applicable
Name: Name:
Address:. Address:
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 work or installation has commenced prior to the issuance of a permit.
St. Lucie County mattes no representation that is granting a permit wiii 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 Suiiding 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
WARMING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to y pro erty. A Notice of Commencement must be recorded and posted on the jobsite
before the first l ecti . If you intend to obtain financing, consult with Ie,�der o� attorney before
commencin rk a cordin our Notice of Commencement. �/
Owner/ Lessee/Contractor as Agent for owner
-E OF FLORI
NTY OF t
s�
The for ing instr nt was acknowledged efore me
this da of 20 by
Name of person ing statemen
Personally Known '� OR Produced Identification
Type of Identification
Produced
{Signature of Votary Public- State of
��dSSloly•; r ����i
ixar.�aaar�
50�50
` Contractor/License Holder
STATE OF FLORIDA �
COUNTY OF
The for ing instr ent was acknowledged before me
this day of 20: Jq y
Name of perso along stateme t
Personally Known OR Produced identification
Type of Identification
Produced
4
Signature of Notary Public - State of Flow }• 'off ON '•.
4.Q'RUARY?E1a�•.
ComA6§flPJA L. BLACK �a
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PLANS VEGETATION SEATURTL A�` �'���u"�er�`.•�,�,
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