HomeMy WebLinkAboutBuilding permit applicationALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ! Permit Number:
3
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11.9 a
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: 14 1 C_ CjrACU\
PROPOSED IMPROVEMENT LOCATION:
Address: LQUA`I
Legal Description: k_, - I( —7S L—b
Property Tax Id #: 1 SDLP `,5DQ r � + _ — �" Lot No.) :7
Site Plan Name: Block No. 7
prniart Namp-
Setbacks Front Back: Right Side: Left Side:
j1wV\0f,
CONSTRUCTION INFORMATION:
Additional workto e e orme 1 1 er t is permit— c ec a appy:
RIHVAC Gas Tank Gas Piping _ Shutters EE] Windows/Doors
11 Electric El Plumbing Sprinklers LJ Generator Roof Roof pitch
Total Sq. Ft of Construction: �y S Ft. of First Floor:
Cost of Construction: $ 7 0 • Utilities: Sewer Lei Septic Building Height:
OWNER/LESSEE; CONTRACTOR:
Name �l'--0 :2i �. I I eY cSCN} Name: James Snyder
Address: (� ap oU Company: Snyder's Cooling and Heating, Inc.
City:State:. Address: P.O. Box 2007
Zip Code: �J� CtFax: -- City: Fort Pierce State: FL
Phone No. rT o2 J Dot ?qtp Zip Code: 84864 Fax: 772-600-4811
E -Mail: �� Phone No. 772-528-3377
Fill in fee simple Title Holder on next page ( if different E -Mail: snyderscooling@aol.com
from the Owner listed above) State or County License: CACI 8165791 #26414
If value of construction is $2500 or more, a RECORDED ]Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT9N UEN LAW 1NFORMA T [ON:
DESIGNER/ENGINEER: _ Not Applicable 'MORTGAGE COMPANY:
Name:
Address
City:
Zip:
Phon
State
FEE SIMPLE TITLE HOLDER: k' Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address;
City:
Zip: Phone:
BONDING COMPANY:
Name;_
Address:
City:_
Zip:
Phone:
1�-f of Applicable
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 permit.
St. Lucie County makes no representation that its granting a permit will authorize thepermit holder to build the subject structure
which is in comlict 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 1 will, in all respects, perform the work
in accordance with the approved pians, the Florida Building Codes and St. facie 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 ins tion. If you intend to obtain financing, consult with lender or an attorney before
commencinK w or.i ding your Notice of Commencement.
If Owner{ Lessee/Contractor as Agent for ownerI lof Contractor/License Holder
STATE OF FL STATE OF FLORIn
COUNTY OF c_l COUNTY OF -}
The forgoing instrL ilent wa acknowledged before me
this � day of i 2tQbY
J 0_V -r\ e's ov
Name of person making atement
Personally Known ✓ OR Produced Identification
ype o entif1cation
Produced
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(Signature of Notary Public- State of Florio) . *-,fO
Commission No.
SABRINA L. BLACK. s$:oc2sssea
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REVIEWS FRONT ZlfG�i/°raj.>`RV15QR`3'
COUNTER REVIEW f': REVIEWti;;�kr
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
The for ing instru ent was acknowledged before me
this day of �` 20C�0by
Name of person 111zlong statement
Personal) Known OR Produced Identification
ype of ldentification
Produced
—I� I+va c 8 �M,
.a�::ssfi, .�9�,A'
gnature of Notary Public- state of Flar a) l �(tilA'k2,
Cc mission No. _ �%al) ••�
* SABRINA [! . BLACK `�. 2888x2
r9.�••�°�nged-
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PLAINS VEGETATION SEATURTL�//�����
REVIEW . REVIEW