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HomeMy WebLinkAboutBuilding permit applicationALL APPLI ABLk INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 13D ab �, (� Permit Number: c�JaWt_y am" --� Building Permit Applications Planning and Development Services Building and Code Regulation Division r 2300 Virginia Avenue, Fort Pierce FL 34992 Residential Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: b K , PROPOSED IMPROVEMENT LOCATION: Address: ao 7. // �� d a5 rA-v�+-� �- -7 Legal Description: ►���` V U e'' Property Tax lD Site Plan Name: Project Name: Setbacks Fron# Back: Right Side: Left Side: DETAILED DESCRIPTION OI= WORK: �-� 0-U4 — fig° L; � , 5 K� 5&ew � Lot No. Block No. CONSTRUCTION INFORMATION: Additional worK to e eFrorme u n-d er t is permit - c ec a app y: HVAC Gas Tank Gas Piping Shutters Windows/Doors Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: sq. Ft. of First Floor: Qo Cost of Construction: $ _ Utilities: _Sewer Septic Building Height: J OWNER/LESSEE: Name G�k` -_ t rl rh ; ©f t -t— Address: tit ;� r Sr r0��7 City: _P o { -�- 1- c State: a Zip Cade: -_3 � 67S2- Fax: Phone No. LDD -Da s l i E-Mail: f� Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Name: James Snyder r _narw, Snyder`s Cooling and Heating, Inc. Address: F.O. Box 2007 City: Fort Pierce State: FL Zip Code: 34954 Fax: 772-600-4811 W,r . n Ain 772-528-3377 c' KA.,il. snyderscooling@aoLcom State or County License: CAC18165791 #26414 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCT19N LIEN LAW INFORMATION: MORTGAGE COMPANY: DESIGNER/ENGINEER: Name: Address: City: Zip: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone:_ Applicable State: ✓ Not Applicable Name: Address: City: Phone, Zip: Phone, BONDING COMPANY: Name: Address -- Zip: - Phone: Not Applicable State: -"Not Applicable 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 permitauthorize tf�e .. ct structure St. Lucie Count makes no represntation that Owners a permit mi wu ll, by aws or and evenarmit ptds that mayer to drestrictthe borprohibit such which is in con list with any applicable 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 ail respects, perform the work in accordance with the approved plans, the Florida Building Codes and 5t_ 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 in our ce for WARNING TO OWNER: pA Noce ofCommen Commencement must be recorded aa Notice of Commencement may tnd poste paying n theijobssiite before ements to Yourproperty. before the first ins tion. If you intend to obtain financing, consult with lender or an attorney before commencing wo or reca our Notice of Commencement. J Lessee/Contractor as Agent for Owner STAIrEOF FLORIDA.I COUNTY OF The forgoing instru nt was acknowledged before me this day of Ak/ti"a"r 20�c4by Name of persoD.-making tatement Personally KnOVJnV/OR Produced Identification Type of identification Produced `,,`w11111041 r,� .•�o�aissroy,�:. (signature of Notary Public- state of Florida) T . (Seal): Commission No. a .g SABRINA L. BLACK REVIEWS FRONT � ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 0.a-0 #GG 289862 04aea ito r\. Contractor/License Holder STATE OF FLORIDA S � J_LA CA - COUNTY OF �� The fosa�oing instrum nt was acknowledged before me this rip day of 20.� by �� .L S CJ� +ems✓ Name of person aking statement Personally known OR Produced Identification Type of Identification Produced ure of Notary Public- State of Florida i 3sion No. O SABRINA L. BLACK PLANS VEGETATION SEA TURTLE REVIEW REVIEW REVIEW 111111111 RINA f 5