HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO MAST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
nate: , F
i5 r,� b A o . Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ice!
Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: /4 j L C iOJA OU- 4y'
PROPOSED IMPROVEMENT LOCATION:
Address: IJ LaA< e, +Legal Description: 56_ c5k L -4,.,64 1A 15 bl—AI o�
Property Tax ID #: '560 - d — (M ,,5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
A itlona wor to nri:Orme un er t �s permit — c ec a app y:
®HVAC Gas Tank E]Gas Wiping _ Shutters D Windows/Doors
11 Electric Plumbing Sprinklers ElGenerator Roof Roof pitch
Total Sq. Ft of Construction: 5 Ft. of First Floor:
Cost of Construction: $
+, 6° Utilities: Sewer I]Septic Building Height:
t �[
OWNER/LESSEE: „ CONTRACTOR:
Name I,Ii nCs7
Address: -5 LC-�<Z �
City: a f 4, L -u -u State: .
Zip Code: Fax:
Phone No. ~ .'99R " Dc70
E -Mail:~
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Nam,. .lames Snyder
Company: Snyder's Cooling and Heating, Inc.
6rielrpcq• P.O. Box 21707
City: Fort Pierce State: FL
Zip Code: 04954 Fax: 772-600-4811
Phnnp Nn_ 772-528-3377
F_hAail, snyderscooling@aol.com
State or County License: CAC18165791426414
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTjPN LIEN LAW INFORMATION:
QESIGNER%ENGINEER: _Nat Applicable MOIiGAGE COMPANY:
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
l'ihf-
Zip: Phone:_
State
✓Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:
Zip:
Pho
✓Not Applicable
Applicable
OWNER/ CONTRACTOR AFFID4/IT: 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 iconflict 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.
n
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 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 your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first i pecti n. if you intend to obtain financing, consult with lender or an attorney before
commencing rk o ecordin our Notice of Commencement.
of Owner/ Lessee/Contractor as Agent for owner
STATE OF FLO
COUNTY OFA+
The forgoing instrument was a knowledged before me
this � day of i . 200 by
Name�e�
nemakstatement
Personally Known OR Produced Identification
Type of Mentification
Produced
{Signature of Notary Public- State of
P7D� Wrr�
Commission No. —
SABRINA L. BLACK.
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE —
COMPLETEI]
Rev. 8/2/17
of Contractor/License Holder
STATE OF FiORIgA��
COUNTY OF ��
The forgoing instrument was icknowledged before me
this day ofd-G��-- 24".by
Name of person along statement
Personally Known OR Produced Identification
Type of Identification
Produced
v { gnature of Notary Public- State of Florida
�pw • Cbbmission No.'i.7 �-AV U��--ss' S0 9— yj {
Q •F' 'Gila *� ii[F�v.i i.... BLACK
Un esw•`•••. .?'4RPLANS VEGETATION SEATURTLE
'fRA} ,►t\�� REVIEW REVIEW REVIEW