HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 45 1.2-1 Permit Number:
LEI
> 4400-
Building Permit Application
q (5 1,.)-1
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: 50 01 k. r k. Pr We'e__ 3qqq
Property Tax ID#: O�c"�0 [ - 33a — CzL I ` 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:
(/M echanical _Gas Tank —Gas Piping _Shutters _Windows/Doors Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:.
as
Cost of Construction: $ 4/o� 0 d Utilities: —Sewer _Septic Building Height:
OWNER LESSEE: CONTRACTOR:
Name e.1C;L Name:James Snyder
Address: 5®Q v14ew- K61 . Company;Snyder's Cooling and Heating, Inc.
City: 22 State: Ft. Address:P.O. Box 2007
Zip Code: 314 q 415 Fax: ® City: Fort Pierce State:FL
Phone No,_ -7-73 e gag- 1 flaff 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-Mailsnyderscooling@aol.com
from the Owner listed above) State or County License CAC1 816579/26414
It 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: L Kot 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:
Zi p: 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 lender 9T59if a;torney before commencing work or recording our Notice of Commencement.
Si of Owner/Lessee/Contractor as Agent for Owner 110 e of Contractor/License Holder
STATE OF FLORI STATE OF FLORIDA /
COUNTY OF (T �vt c—! COUNTY OF Cyr, t L
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
✓Physical Pres ce or Online Notarization ----ph sisal Prese ce or Online Notarization
this��dday of f , F 202t by thi�J��-+ day of ✓i 202 by
J n aL-'L--2 J 0-*_e_s
Name of person making statement. Name of person making statement.
J0%M1111Ndtpr
Personally Known OR Produced Ide\ iv c��jl + 9��i io Personally Known � OR Produced Identific\tio\%111�111111�0 /
Type of Identification ���� o�Mtssio �9 Type of Identification `\\`• SA��?/�Vq�
Produced �y�e��an,y2�A•�f roduced •yGOMMISsj0.
�� i s• o�N x �FEBR�A S'Y i_
(Signature of Notary Public-State of Fla'Ufa 289862 ,signature of Notary Public-State of Floridan e d 'G
ped 101e�y' k / 89862 w
Commission No. � G0� O& '6�, Undes "�. ��0� -Commission No. �U �� (Sel �p°���edrhru s
SABRINA L. BLACK STATEOFF;�\\\\` SAEi(Zlltf L. �,"�t�i�STq nderw��?o�
� `' t�dPfItE9N1�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.