HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10A 1 I do ao Permit Number:
T� L U. LGC-`
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ABC Change out - Like for Like
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #:
Site Plan Name: _
Project Name: _
-DETAILED DESCRIPTION OF WORK:
r^ 0 kn in/it n I
o�-+,-Q— ° ':� f-an . 1 10 c5 ee'v- P J J * A K CJ h4�0111'_A,-
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION;
Additiioo al work to be performed under this permit —check all that apply:
►® Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
— Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:: Sq. Ft. of First Floor:
Cost of Construction: $ (S �bbb , Utilities: —Sewer —Septic Building Height:
a
Lot No.
Block No.
OWNER/LESSEE:
CONTRACTOR:
Name LA,1J)
: 05 r `-fGl. - Al
Add re's's`
Name: James Snyder
Company:Snyder's Cooling and Heating, Inc.
,
W City: d 4 0_yp_VL State: F/.
Zip Code: g�— Fax:
Phone No. gta_� - I 01N - 17 36
Address: P.O. Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Phone N0772-528-3377
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 / 26414
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
I'
SUPPLEMENTAL CONSTRUCT�PN LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ` Not Applicable
MORTGAGE COMPANY: _ of 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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie Count d posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with len o n attorney before commencing work or recording your Notice of Commencement.
i ture of Owner/ Lessee/Contractor as Agent for Owner
ure of Contractor/License Holder
STATE OF FLORI p Vl_ LA
STATE OF O ID
COUNTY OF �. �
COUNTY OF'44
Swor�Tto (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
If Physical Pres ce r Online Notarization
this day of . 6a•�/ 2020 by
�hysical Presence or Online Notarization
this pday of D � 2020 by
c�srJ,-
J o_me,�s (_SaJeV-
Name of person making statement.
Name of person making statement.
Personally Known ✓OR Produced Identification
Personally Known ✓/ OR Produced Identification
Type of Identification
Type of Identification
Pr uced
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Produced
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5Jignature of Notary Public- State of FlAa J:�� e o F•. f
(Signature of Notary Public- State of Floofa ).a�a to` ;••
e�,�RY�
Commission No. poi o � �., mm :
C$nmission No. V 6-02����a= ' Seal �•�
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S.A B R I NA L. BLACK � #GG 289862 `y :
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