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HomeMy WebLinkAboutHollett - 170 SE Calmosa Dr SLCAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I I�I� I Permit Number: 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: -7 © c5F a_I 5GL Property Tax ID #: c341 I �%- — 5 5 p - ©C) ?j 9 _ % Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: V DFr/; Lot No. — Block No. Additional 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: $ _ & fld - �— Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: NameJ Name:James Snyder Address: c5 iv S6-- r , City: 1) T_� L_y-tri q.-- State: zip Code: 3 q 0J g 3 Fax: Phone No. '722 ,-417- 6-3,37 Company:Snyder's Cooling and Heating, Inc. 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 IT value or construction is ZSUU 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. SUPPLEMENTAL CONSTRUCTION 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 and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lend or an attorney before commencing work or recording o r Notice of Commencement. ure of Owner/ Lessee/Contractor as Agent for Owner ure of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA" .� L-I COUNTY OF �t". ui Q_._ COUNTY OF Ll Swor o (or affirmed) and subscribed before me of Physical Presence Online Notarization Sworn to (or affirmed) and subscribed before me of or sical Presence or Online Notarization t�k this day o G�-tnu_ow 202tp by dayof a:LNLA_Lw 202by oaliYl� S �n �-� d �✓ �a r slieN Name of person making statement. Name of person making stateme t. Personally Known ✓ OR Produced Identification ���IHilllly/JJ Personally Known ✓ OR Produced Ident4{-NA��j/� Type of Identification °j°\\Not It1!I1/1 Type of Identification w�`\ �'P��,;� sioy • 'C' Produced `\\`�SpFiv?�.8� A.R Ef o Vroduced� cr��„ti�2F�o�•. 71r yV Y2 (Signature of Notary Public- State of Florit`fa� : "� N' ? oz8'� sssz ; (Signature of Notary Public- State of Florid.L ,•. �. ' //��� d Commission No.l�t3 0� 0 ���Ao�l : o #GG28 62 ( sllY'% " * = q8�a, y%^� 3! blaed ttle�.e��•O Commission Ni ( un a 5 SABRINA L. BLACK ���� , f Ab//dedihN i\e`O c under • \N �` � IM�fA �. BLACK REVIEWS FRONT ZONING TATE OF SUPERVI&dFi°° \` PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 516120