HomeMy WebLinkAboutBuilding PemitALL APPLICABLE INFO MAST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
(
Date: l + ti -I I ac) Permit Number:
o.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: UJ_
b Kt, 0
PROPOSED IMPROV MENT LOCATION:
Address: I 5 1 O nav 70r.
Legal Description: I ' f UJ - c`_,v iL , " A- -7 % Li i 145
Property Tax ID f#: L3 q l q-7 Lot No. -7
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
IL3 3
1q sem,
CONSTRUCTION INFORMATION:
Additional work -to be ertormed under this permit - c ec a appy:
®HVAC Gas Tank F]Gas Piping Shutters Windows/Doors
® Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 3 �'S 0, --- utilities:E Sewer Septic Building Height-
OWNER
eight:
OWN ER/LESSEE:
CONTRACTOR:
Name JG_, Q -►l e
Name: James Snyder
Address: fl YYl der 1r .
Company: Snyder's Cooling and Heating, Inc.
Cit, State: EI
Zip Code: .3-i L16 a Fax: -
Phone No. --� �� i fl
Address: P.O. Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-6DD-4811
Phone No. 772-5283377
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: snyderscooling@aol.com
State or County License: CACI 816579 l #26414
If value of constructions is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT N LIEN LAVH INFORMATION:
;re
DESIGNER/ENGINEER: —Not Applicable
MORTGAGE COMPANY: of Applicable
Name: i
Dame:
Address:
Address:
City: State:
City: State:
Zip: Phone
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 inoacatea.
I certify that no work or installation has commenced prior to the issuance of a permit.
5t. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con lict 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, 1 do hereby agree that l will, in all respects, perform the work
in accordance with the approved pians, the Florida Building Codes and St_ Lucie County Amendments.
The following building perm'st 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 your prop y. A Notice of Commencement must be recorded and posted on the jobsite
before the first ' ectio you intend to obtain financing, consult with lender or an attorney before
eommencin rk or cordin Ntniir Notice of Commencement.
atu € Owner/ Lessee/Contractor as Agent for Owner
;re
ontractor/License Holder
ST TE OF FLORIDA,r
�u`
STATE OF FLORIDA
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COUNTY OF �7 �+ 'may _
COUNTY OF C `����-
The for Ding instru t was acknowledged before me
day 20D by
The forgoing instru t was acknowledged before me
this � d� G�-LA G.✓ zap by
this of
P�
I
Name of perso aking sta ement
Name of pers akin�statemerlt
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
41444#�1J11/�jZ
X`A�11tN'A !!1// y
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(Signature of Notary Public
-�QSjtate of Florida
(Signature of Notary Public- State ofQr!FPX--11 s�� c�5,moi
Commission No. v Aim °�~R�� "a'�;•,
Commission No. &6r (Sea])
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SABRIN
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REVIEW
DATE#1141t1i1
RECEIVED
DATE
COMPLETED
Rev. 8/2/17