HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: b a-7 )a a a-fl
Permit Number:
r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772)462-1SS3 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: O 0-� b-vY1 -D(. �aY id1X l
Legal Description: V)6 ;a ,i1 P J� a �S [�_�1 ; 09 �� K g Z b. I 1p
PropertyTax ID#: 5q 3 ' (DC)C) - 9 Lot No. /b
Site Plan Name: Bloch No..
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
J_ 4-ov) h e ajo�
CONSTRUCTION INFORMATION:
Additional workto e e Dime un er t Es permit c ec a app y:
�HVAC Gas Tank Gas Piping _Shutters Windows/Doors
DElectric 0 Plumbing 05prinklers M Generator E I Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
po
Cost of Construction:$ Utilities: 0 Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name e,V III I W Name: James Snyder-
Address: 10 LA � Company: Snyder's Cooling and Heating, Inc.
City State: Address: P.O. Box 2007
Zip Code: 5u67yr . Fax: City: Fort Pierce State:FL
Phone No. -7-7d\ "oZ 33 - )_t �tv Zip Code: 34954 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: CACIS16579 i#26414
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION UEN.LAW INFORMATION.
DESIGN ERIENGINEER: _ 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: _ of Applicable
Name: 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 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 auilding 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 with lender or an attorney before
commencing rk oe;ilcording your Notice of Commencement.
e of Owner/Lessee/Contractor as Agent for Owner �gn -TATE f Contractor/License Holder ATE
COUNTY OF _LA OR{€7f1�, � � COUNTY OFQRIDA
The forgoing instr ent was acknowledged before me The f�ing instruZ nt was acknowledged before me
thisdayof 2�by this (�dr� _6_;�Oby
)� "JeAI— ! S
I Name of perso aking statem nt Name of person king statement
Personally Known OR Produced Identification personally Known OR Produced Identification
Type of identification Type of identification t\\\\\����i li+ fill,
Produced Produced ;4\ rpBRINA4 6 �z
`
\\1tNi1111lfll/11Z
� r� o•.�
(Signature of Notary Public-State of Florid �?.a�t1� iMFxoi•.•j gV
nature of Notary Pubiic state ofJiLI ) Gz���'
f? ,�) a
Commission No.G& 0&I? %�aIf 11k4 2�D��I-C ission No.&6 020 �+!Dd�����ea}�A°tnc�tau`'•'
L. BLACK _* : r►•e f ;ii � ••.
tll
SABRINA
ice zs9862 €• ? S�B 1 NA L. 8 LAC K�'�i���,`lI� >LfndeQr
�.2'•o m�N•O�
a Bc�'.•I cJ
REVIEWS FRONT ZONING �ii y u6 1 F \ LANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW %i Loll, EVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED