HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICttA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A A Permit Number:
LLLL"E
L `v" 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 IMPROVE ENT LOCATION: Q
Address: D ,I In e S21�Cre 3 t��'
Property Tax ID#: c24D3 C561 r y - bc)E) `�
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Lot No.�320
Block No.
(� MW�m % S -f) . / LO Se_Lj tj �� �-�
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to he performed under this permit —check all that apply:
yMechanica€ _ Gas Tank _ Gas Piping Shutters _ Windows/Doors � Pond
_ Electric —Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 91A60 • Utilities: _ Sewer _ Septic Building Height.
OWNERAESSEE:
CONTRACTOR:
Name
Name: James Snyder
Address: iff
Company: Snyder`s Cooling and Heating, Inc.
I
H City: /$.y-&a__, State:
Zip Code: 3LI " 1 Y ,)— Fax:
Phone No. —7—7a J7 3 a 3 ys
Address: P.O. Box 2007
City: Fort Pierce State: FL
Zip Code: 34954 Fax: 772-600-4811
Phone No772-528-3377
E-Mail:
Fill in fee simple Title Folder on next page( if different
from the Owner lister! above)
E-Mail snyderscooling@aol.com
State or County License CAC1816579 1 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.
0
SUPPLEMENTAL CONSTRUCTIN 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 TITLEHOLDER* Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
city:
Zip: Phone:
i
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, l 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 an:,posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender n attorney before commencing work or recording our Notice of Commencement.
ignature of Owner/ Lessee/Contractor as Agent for Owner
i ature of Contractor/License Holder
STATECOUNTY OFORI( -) L k A--
COUNTY OFSTATE OF ORID�
Swor to (or affirmed) and subscribed before me of
V Physical Pre or Online Notarization
This -Delay of Q-� L 202V by
5wor to (or affirmed) and subscribed before me of
'/ Physical Presenceor Online Notarization
this O�P day of 202V by
Name of person making statement.
Name of person making statement.
Personally Known 1' OR Produced Identification
Personally Known OR Produced Identification
Type of identification
Pro ced ;111U1111ilfPfJf//,�
R`NAL.e
l - 2-21
Type of Identification
Produced
�o��MAL11J1//foci
(signature of Notary Public- State of.� orid�`). �o �� ,
a.es
Commission No. 52eat)
p 1jg�} y���ry �aa y� MG 289882
(Signature of Notary Public- State of FI a ),• � kssioy,''
Commission No. �U�� y �� �5te A
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SAR INA L. BLACK
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