HomeMy WebLinkAboutRuble - 6904 Fort Walton Ave SLCAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 1 d-1 3)aaa ® Permit Number:
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L L c -¢`� 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: A/C Change out - Like for Like
PROPOSED IMPROVEMENT LOCATION: Address: LPq0H cp e 19
. R � ,
Property Tax ID #: - 51301 - WA - 01 LO LQ ` C100 '-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCT1flN INFORMATION:
Add iti al work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric ` Plumbing , Sprinklers
Total Sq. Ft of Construction,,:[[/I ll
Cost of Construction: $ `�`i't o - ot®
_ Generator
V
Lot No. °—
Block No. M&
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
_ Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
I.L Q
uJole
Name:dames Snyder
Address: VV014nn
company:Snyder's Cooling and Heating, Inc.
City: _-�-. 49; Q'1%G State: _.
Zip Code: 3415 1 Fax:
Phone No, r_3oN --5bO b DLP
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 CAC1816579126414
It value or consxrucrion is L5uu or more, a RECCRDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTt
LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _
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: 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 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 County an osted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender gF4n attorney before commencing; work or recordiniz vour-Notice of Commencement.
re o Owner/ Lessee/Contractor as Agent for Owner
gnaiure of Contractor/License Holder
STATE OF FLORI
COUNTY OF L
STATE OF FLORID
�•
COUNTY OF �-n�^-�'
Swore to (or affirmed) and subscribed before me of
Swor to (or affirmed) and subscribed before me of
Ph sical Presen e o Online Notarization
Physical Presence or Online Notarization
this 2 day of �Q�Ur� KJW 2020 by
this day of 2020 by
a,vy) �e_s �Sk�-O6teAo
Name of person making statement. I
Name of person making statement.
Personally Known OR Produced Ident��it1M11/�i,,.
Personally Known �OR Produced Identification
Type of Identification L—��'T v,
Type of Identification ,t,01tiip+pi�����`
,��\\���P�RtNA
Produced ` �. .•vowvsONA �-
te
Produced \\\ra'��PgttINAL Btw
.• p ON��'
(Signature of Notary Public- State of Florida }
fSignature of Notary Public- State of Flo.� Y m .
Commission No. "( a p°nUedlh�� i,\". o
Commission Not_Ao#GG289 62
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REVIEWS
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VEGETATION
SEA TURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
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COMPLETED
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