HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� a 0 Permit Number:
u L.; `' 7" Y L' w` Building Permit Application
Planning and Development Services /
Building and Code Regulation Division Commercial Residential ��ff
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 fax: (772)462-1578
PERMIT APPLICATION FOR: A/C Change out - Like for Like
PROPOSED IMPROVEM'LIENT LOCATION:
Address: ��� I n� (��.P� r • L� �79 .2 ,` , i
Property Tax ID 4: — a 6C� - Lot No.7 q
Site Plan Name: Block No. 7
Project Name:
DETAILED DESCRIPTION OF WORK:
v C
ram 5� _ 1 U 5ee_� U'J 0 Kw
New Electrical Meter Second Electrical Meter
[CONSTRUCTION INFORMATION:
Addition I work to be performed under this permit—check all that apply:
echanical —Gas Tank Gas Piping _Shutters _Windows/Doors Pond
— Electric _Plumbing —Sprinklers J Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft, of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ely-O—V Name:James Snyder
Address: r e Company:Snyder's Cooling and Heating, Inc.
City: lL State:. Address:P.CU- Box 2007
Zip Code: Fax: City: Fart Pierce State:FL
Phone No. Sle 1 — 67Y 1 _ 6�Le is 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
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
1f value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT I N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: v Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Nat Applicable BONDING COMPANY: _ZNot Applicable I
Name. Name:
Address: Address:
City: City:
Zi p: Phone: Zi p: 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. Nease 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 posted on the jobsite before the first inspection. if you intend to obtain financing, consult
with lenderdran attorney before commencing work or recording r Notice of Commencement.
Owner/Lessee/Contractor as Agent for Owner ature of Contractor/License Holder
STATE OF FLORID STATE OF FLORID
COUNTY OF ( j—"�'u]� COUNTY OF'
F L--
Swor o(or affirmed)and subscribed before me of Swor a(or affirmed)and subscribed before me of
Physical Prese ce or Online Notarization Physical Presence or Online Notarization
this� day of f 202P by this —day of 202� by
Name of person making statement. Name of person making statement.
Personally Known "� OR Produced Identification Personally Known '�OR Produced Identification
Type of Identification �!!i6l9E!!!illi Type of Identification ,\1��11�{11ti !�
Pr eed �s;� 5p8RIt�A( �r®�� Produced ��� F�R!l�'A�.
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(Signature of Notary Public-State of FZri ) N; I tignature of Notary Public-State of Flc ici�j w N
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Commission No. ����� � �c2a9862 .�$commission No. �v u� Blv,�
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED €
DATE
COMPLETED
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