HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dilate: D ``� a,o,2O Permit Number:
�. i 3
M-911101141....
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: -70 2
Le&,W,Description: _
-V .2
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
DE/T`AILE6D DESCRIPTION OF WORK:
Q51�. e� g 10
rI IflL13-D LAJ(Lsf-
Right Side- Left Side:
Lot No.129......_....�
Block No.
CONSTRUCTION INFORMATION:
bona wor to (ee orme un er t is permit— check a app y:
RjHVAC Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
11 Electric El Plumbing Sprinklers 1 Generator Roof L Roof pitch
Total Sq. Ft of Construction: S�Ftj of First Floor:
Cost of Construction: $ 8 3 Q - — Utilities: LJ Sewer D Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: James Snyder
Address: � A I_
Company: Snyder's Cooling and Heating, Inc.
City: �(Z{�- (s ex �� T _ State.
Zip Code: o (p Fax:
Phone No. `7� ,o - LP I'2
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: snyderseooling@aol.com
State or County License: CAC1816579 / #26414
-,,c��U u1 111UIC, a Rct-UMVrU 1VOLICe O7 LOrnmencement is required_
SUPPLEMENTAL CONSTRUJ N LIEN LAW INFORMATION:
DESIGNERIENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: � Not Applicable
BONDING COMPANY: Applicable
Name:
_Nat
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 indicated.
I certify that no work or installation has curnmenced prior to the issuance of a permit_
St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conliict with any applicable Horne Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Nome 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 inspection. If you intend to obtain financing, consult vyr th lender or an attorney before
commencing or recording our Notice of Commencement.
Si ur Owner/ Lessee/Contractor as Agent for Owner
n e of Contractor/License Voider
ST E OF FL OR J)
I COUNTY OF.. G�-a�c�.._$-
STATE OF FLORIDA f
COUNTY OF.
wledged before me
this � ay of 20 .70by
The for ping inst79LF
The forgoing instru nt was ackpowledged before me
this ay of L u6r 20,0 by
cam%
Name of perso aking statement
Personally [mown �COR Produced Identification
Type of Identification
Name of perso aking statement
Personally Known �C]R Produced Identification
Type of Identification
Produced
Produced
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{Signature of Notary Public- State of rid�.�M►s5�pi {,/�i�
�� gRupRy��, � �
Commission Na G R �a = ; (Sea` �' +�:
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SABRII�A L. BLACK s� �G .
i {Signature of Notary Public- State of Floida) '�ca ss�oy •, y
�, � • ��E6RUARya �.o
Commission No.� 9 B 60 = -Neal) ,
Q" y BLACK
SABRINA L. BLACK w��; Ao�GzB��c
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DATE
RECEIVED
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DATE
COMPLETED