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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:- -7113 1 _aoa-o Permit Number:
w
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
Address: Y 1
Legal Description:
e- —t K/ i n,1 C111A
Property Tax ID #: — ��� • �ex� - �C7� Lot No._1 a
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
M�, aiaAA-cy, ovi e- P��
?�A� I l s e �1 ��� e
FCONSTRUCTION INFORMATION:
1AUUiuUf1d1 worK LO oe errormecl under this permit— check all Lhat apply: -
C�HVAC D Gas Tank Gas Piping Shutters
_
Electric Plumbing ❑Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction. $
S Ft. of First Floor: _
Utilities:CnSewer ❑Septic
❑ Windows/Doors
Roof Roof pitch
Building Weight:
OWNER/LESSEE:
CONTRACTOR:
Namjresp:6
Name: James Snyder
Add'I(u_
Company: Snyders Cooling and Heating, Inc,
City:r r-�n Q_ State. R
Zip Code: �596) ( Fax: --��
Phone No. j_ —c5� c3t-i�p
Address: P.O. Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
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: snyderscooling@aol.com
State or County License: CAC1816579 / #i:26414
.�•..� .+� —.1.L. .—VII 7J ?LJUU UT FF1Vlf , d NCLUKUCU Notice OT [LOMmen cement is required.
SUPPLEMENTAL CONSTRUCTI N LIEN LAW INFORMATION:
RESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _L111ot Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: � Not Applicable
BONDING COMPANY: .�Kot Applicable
Name:
dame:
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 indicated-
[ 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 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 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 insp io . If you intend to obtain financing, consult with lender or an attorney before
commencing wo-k cir_;;ecording your Notice of Commencement.
i to of owner/ Lessee/contractor as Agent for owner
a ontractor/License Holder
s TE OF FLO I
COUNTY OF
STATE OF FLO B
COUNTY OF
The forgoing instru t was acknowledged before me
this day of 20 C90by
The ing instru w s acknowledged before me
! this for day of 2Cl �y
AeA/
I ns
Name of persn aki stet meet
Personally Known 1� OR Produced Identification
Name of perso making statement
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
11Ni1lllflfll///�f/
i
{Signature of Notary Public- State of Florid § �' • s8s�p Zy
C Commission NoSeal
. `���� ?ate ,;
SABRINA L. BLACK.
O '.o �289
o, Signature of Notary Public- State of Florid:�• �'.
Omission No.& 9 a v*� �� .
SABRINA L. BLACK % ? 5
I>� � d � G
REVIEWS
FRONT
COUNTER
ZON1l1l/`
REVIEW //
�do
/ �
�LANS
\ ZEVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
DATE
llill1111111
RECEIVED
DATI=
COMPLETE[]
Rev.S/Z/17