HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 t') 6 a" Permit Number:
r~O'� 'I
3 U , a 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: qqq Ir. c5L- 3L4qVP
Property Tax ID#: 3 -v 8-7 - -7 oc) - Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION.
Additional work to be performed under this permit-check all that apply:
LII echanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: c Sq. Ft. of First Floor:
Cost of Construction: $ �c d(� �` Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name-c�—h 5 W i& V� abJO Name:James Snyder
Address: q q1 V e- Company:Snyder's Cooling and Heating, Inc.
City: PvV 51 State:( Address:P.O. Box 2007
Zip Code: �jL[�/ $ Co Fax: City: Fort Pierce State-FL
Phone No,��o� (Q( ��j Zip Code: 34954 Fax: 772-600-4811
E-Mail: Phone N0772-528-3377
Fill in fee simple Title Holder on next page(if different E-Mail snyderscooling@aol.com
from the Owner listed above) State or County LicenseCAC1 816579/26414
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _blot Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _�ot 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 d posted on the jobsite before the first inspection. If you intend to obtain financing, consult
Lucie
lend r n attorney before commencing work or recording your ice of Commencement.
i ture of Owner/Lessee/Contractor as Agent for Owner ure of Contractor/License Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF ( . LLI cAI e- COUNTY OF LLA-c-�
Swor to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical PresegrAce or Online Notarization -"'Physical Presence or Online Notarization
this day of IV I A�ZT, 202# by this lj day of m a� 2020 by
�S I�G�e�✓ RA, e-s J e-A-
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
Produced Produced
(Signature of Notary Public-State of Flo`�c� .G� �ssioy'` ' (Signature of Notary Public-State of Florida-, A6,
On
Commission Nola A b / b 6 tSe� ���UARY2 �. U O( d a�a� a•) 2` m'•
* � o c�'• mmission No. e l N
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SAS'R[NA L. SL.A.CX o �'"'� Sl�BRINA L. BLACK
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