HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -2418 /a 0 a') Permit Number:
Ir. LLCLL
;> .
>= z �` 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:
�r
Address:
,�y� a-�"/—I&C � e_ �l
�) % 7 / / I V�1e,,. � V'�, b� �
Property Tax ID #: 33,E " 505 qA - 0 oz) - S
Site Plan Name:
Project Name:
V
Lot N o. / 33
Block No.
I DETAILED DESCRIPTION OF WORK: I
m
O-V) , l U Se e v- , / 0 l4 &J �) e
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
'-'Mechanical — Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ Cie • o0
Sq. Ft. of First Floor:
_ Windows/Doors _ Pond
_ Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWN ERAESSEE:
CONTRACTOR:
Name (_C> aoloL h
Name:James Snyder
((e,✓
Address: Ill% l� as oLo rci Dv,,
Company:Snyder's Cooling and Heating, Inc.
City: �✓ � 6+. "c,; (- State: r(.
Zip Code: Fax: —'
Phone No. (,Q oil D " 'Za `�.3
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-Mailsnyderscooling@aol.com
State or County License CAC1 816579 / 26414
1r veiue ur construction is z5uu or more, a KLLU DW 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:
j
FEE SIMPLE TITLE HOLDER: _ LI/Not Applicable
BONDING COMPANY: _Not Applicable
j
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 grantingof this requested permit, I do hereby agree that I will in all respects, perform the work
q p Y g p ,
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 lender o an attorney before commencing work or recording your Notice of Commencement.
I
Si ur Owner/ Lessee/Contractor as Agent for Owner
ig ure of Contractor/License Holder
ST:TE OF FLORIDA ) _
COUNTY OF C �t . �1/\-C k�
STATE OF FLORIDA /
COUNTY OF �L 4-'L 'e_
Sw�oto (or affirmed) and subscribed before me of
Physical Prese e Qr Online Notarization
this L day of &v(7 2021 by
Sw, onto (or affirmed) and subscribed before me of
✓ P sical Prese e jar Online Notarization
this day of f'/ 202# by
J QN? ��5 ��./
0�-m =5 S es✓
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identificati R
Type of Identification §\Q�ilf���,,�
Produced §\\\\�'P� s o
�JV"V"^"�" �4 : � �O��pRY 20a�s
Personally Known V OR Produced Identification
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fpr lucelddentification ����\�`\\SP issioy
•� � ��Il. a :;�'��wOR'�AkY2�
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(Signature of Notary Public- State of Florid `• o
� ;
#GG 289862
Commission No,
'i ,� c UndQc?
SABRINA L. BLACK `"/ yA.
: �►.
(signature of Notary Public- State of Florida � •�
2G?89862
ission No. (7 �5 �U� 0�� , (Sew yA�na
f�c d th
\ �� 13 IZ 1 N�a LeBLACK �Lo
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