HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
N.Iji �.M
MINING ORNATt", 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
PERM IT APPLICATION FOR: 41 L � � '°L, V e- � L_ V, �
0
PROPOSED IMPROVEMENT LOCATION:
Address: CD 55 5.`a�v�� i'f2�.r —D,,, . {?. (3Uggd-_
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Property Tax ID #: d — I - 600a - tZb -,3 Lot No. ' b
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: night Side: Left Side:
DETAILED DESCRIPTION.OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to eEiGas
eorme under this permit— check a apply:
®HVAC Tank Gas Piping _ Shutters []Windows/Doors
Electric 0 Plumbing FSprinklers I Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: S�Ftj of First Floor:
Costo#Construction:$, ��.. -_ Utilities:LJSewer Septic
,.
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 41&4yl
Name: James Snyder
Address:.s +GX� �I PJ✓
Company: 5nyder's Cooling and Heating, Inc.
city: I1 State:
Zip Code: ' Fax:
Phone No.
Address: P.O. Box2007
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: CA018165791 #26414
Iv01uC v1 Wubirucuon 15 �k4Suu or more, a Ktt.UKWLU Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTI N LIEN LAW INFORMATION:
RESIGNER/ENGINEER: V Not Applicable MORTGAGE COMPANY: � Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE FOLDER: _ Not Applicable BONDING COMPANY: _Not 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 Count 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: roam 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 fir�Kq�eco*rding
If you intend to obtain financing, consult with lender or an attorney before
commencinour Notice of Commencement.
i21
Rev. S/2/17
Of Owner/ Lessee/Contractor
as Agent far Owner
rg of Contractor/License Holder
ATE OF FLO I
COUNTY OF
TATE OF FLORI A
� L
COUNTY OF
The forgoing instru ent as acl nowledged before me
this
The forgoing instru��rr ent was a knowledged before me
this day [� � by
ay of , 2D y
of 20
Name of person making statem nt
Name of persa aking statement
Personally Known � OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
{signature of Notary Public- State of 1=io``�\�A�R1NAi.,
(Signature of Notary Public- State of Flo y�) ,Go��Js�oN�p�•,
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Commission Na
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