HomeMy WebLinkAboutBuilding Permit Application Ali APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D Permit dumber_
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Building
Planning and Deveiopment Services
Building and Code Regulotion Division Commer i l Residential
23 00 Virgi n is A ven ue, Fo rt Pierce FL 34-992
Phone: ) -1 5 Fax: 7 ) -1 7
PERMIT APPLICATION FOR : A/C Change oUt - Like for Like
PROPOSED IMPROVEMENT LOCATION .
r- C i i 5 : -A t-A Q
- I- `7U5 319 54�
Property Tax I D #: Z7 2� Lot No.
Site Plan Naive : Block No.
Project Dame:
DETAILED I PTI N V0RK:--
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Is " e ms ck � Lo
N iew Electrical Meter Second Electrical Deter
CoNST UCTI- .N INFORM T N .
d itio al work to be performed under this permit — check all that apply:
Mechanical Gas Tank Gas Piping � Shutters � Wind ws/Doors � Porgy
Electric Plumbing � Sprinklers Generator Roof Pity
Total Sq.. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction : $ Utilities: Serer Septic Building Height:
OWNER/LESSEE : CONTRACTOR :
Name i N me: James Snyder
Address: f t' r Co pany, ,S yder's Cooling and Heating , Inc.
1 Y, �� State — � l Address.- P. O. Box 2007
. -
�' 96,q . Fort Pierce
Zip Code: - i Fax.-_ - ity: FL
State:
Phone \7 � '734
1 Zip Code. Fax: 77 - -4811
F-Mail : Phone N7 - 8-3377
Fill in fee simple Title Holder on next page if different E-Mallsnyderscooling@aol.com
from the Owner 111sted above} State or County License CAG181 7 126414
If value of construction iis 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''CONSTRUCTI -'L1 E N. LA INFORMAT
DESIGNER/ENGINEER: -- Not Applicable MORTGAGE COMPANY: Not Applicab le
Address : Address :
:
01 t .. .,,, .., -- Stake : Iy: State:
zip.. - - Pin 1 : Phone:
FEE SIMPLE TITLE HOLDER.- Not Applicable BONDING COMPANY: A of Applica e �
Name : Name:
:
Address: Address-
City: city:
! p: Po : Zip: Phone-
OWN ER/ CON TRACTOR AFFIDVIT: Application is hereby made to obtain a perrnit to do the wort( and installation as in JIcated.
i certify that no work or installation has commenced prior to the issuance of a permit,
'. Lucie cu€ t mal es no representati n that is granting a permit will authorize the perm, it hol der to build the subject struct ure
which is in conflict with any applicable Home Owners Association rules b lags or and covenants that a restrict or prohibitsuch
structure, Please consult with e your Horne Owners Association and review our deed for an restrictions v hich a 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. Lurie County Amendments.
The following building permit appficatian5 are exempt from undergoing a full concurrent review; room additions,
accessory structures, swim inn pools, fences, galls, 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.
I. uc!e County are .. bsted on the j o bs ite before tlne first i ns pe ti o n . if you intend to o bta n financing{ con It
with leader n atLorney before commencing work or recording your ,DJLetice of Commencement.
e o caner Lessaeontrator as Agent for owner afore a otractor3cernseIder
STATE F LO I � STATE F FLORIDA
COUNTYFL C lT ' o F L .
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(or affirmed) and subscribed before of wor o (or affirmed) and subscribed before e of
_ sical Pr ►�s or- Online Iotari cation Physical Prey or Online Notarization
7th is day of *� L .�.� 0 key this �[, day of b
Name of person making statement. Marne of person making statement.
Personally Known lo R Produced identificat' PersonallyKnown � R Produced Identification
Type f Eder to icatio Type of Identification 11l4III I
Pr ue /I , Produced ,
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(Signature of Notary ubiic- . t�t�. �
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E r� ' �ignature of Notary Public- State of Floe s rt
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Commission No, C5
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REVIEWS FRONT T l l l NG O1 PLANS VEGETATION SEA TURTLE
COUNTER f REVIEW IEW RE IEW REVIEW REVIEW REVIEW REVIE
DATE
RECEIVED
DATE
MPLE TIED
Rev I {
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