HomeMy WebLinkAboutBanack - 8024 Plantation Lakes Dr SLC.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: )b hq 1A1 Permit Number:
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Building Permit Application
Planning and [Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: A/C Change Out - Like for Like
PROPOSED IMPROVEMENT OCATION:
Address: V2 0A I vv) ZS ✓. br S -
2 2 7
Property Tax I D #: 33 A / w 81),3 - ct) a 3 - cnb - (D Lot No. v?7
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Cv. S Zed Lo;
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 _ Windows/Doors _ Pond
Electric — Plumbing _Sprinklers Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction: $ 5,3 r Utilitles: —Sewer _Septic Building Height-
0 WNER/LESSEE: CONTRACTOR:
Name i Name:3ames Snyder
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Address: y eS It, Company:5nyder's Coaling and Heating, Inc.
City: &' — LSi • LA --a- State: Address:P.O_ Box 2007
Zip Code: Ls Fax: City: Fort Pierce state: FL
Phone No. 34954 772-600-4811p Fax:
E-Mail: --�- Phone No772-528-3377
Fill in fee simple Title Holder on next page ( if different E-Mail snyderscooiing@aol.com
from the Owner listed above) State or County License CAC1816579 / 26414
tf 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 CONSTRUCTI LIEN LAW INFORMATION:
'gNDESIGNER/ENGINEER:
Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Nat Applicable
Name:
BONDING COMPANY: _Not Applicable
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 our property. A Notice of Commencement must be recorded in the public records of St.
Lucie Count posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lend attorney before commencing work or recording your Notice of Commencement.
ure of Owner/ Lessee/Contractor as Agent for Owner
gnature of Contractor/License Holder
STATE OF FLORI 3 _
STATE OF FLORID ]
COUNTY OF
COUNTY OF
Swor o (or affirmed) and subscribed before me of
Ph lsica€ Presa e Online Notarization
Sworn (or affirmed) and subscribed before me of
Ph sicaI Pres ce r Online Notarization
this _q day of 202 f by
4 this day of 2021 by
Name of person making statement.
Name of person making statement.
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Personally Known Produced Identification
Personally Known L_OR Produced Identification
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