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HomeMy WebLinkAboutCollins - 310 Shady Lane SLCAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: J� I oZ�-- Permit Number: 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) 462-1575 N PERMIT APPLICATION FOR: A/C mange out - Like for Like PROPOSED IMPROVEMENT LOCAT ON: Address: 51 UY U '(— &IqSc'?- Property Tax ID #: 000 - © Lot No. - Site Plan Name: Block No. C; a Project Name: DETAILED DESCRIPTION OF WOR : C- -) 6.tnn �- 0 tSe 10 New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: AddZechanical al work to be performed under this permit -check all that apply: _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond Electric —Plumbing — Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: OWNS LESSEE: CONTRACTOR: Name i7 [, x 115 Narne:James Snyder Address: d p Company: Snyder's Cooling and Heating, Inc. City: Lvt1.b :L, State: f-1. Zip Code: Fax: Phone No. q-7 3 - 5-3q -• 5-5 3 7 Address:p-0. Box 2007 City: Fort Pierce State: FL Zip Code: 34954 Fax: 772-600-4811 Phone No 772-528-3377 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail snyderscooling@aol.com State or County License CAC1816579 / 26414 It value of construction is 2504 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 CONSTRUCT19N LIEN LAM INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: __VNot Applicable BONDING COMPANY: _Not Applicable Name: 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: roam 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 or ttorney before commencing worlk or recording your Notice of Commencement. I e of Owner/ Lessee/Contractor as Agent for Owner ature of Contractor/License Holder STATE OF FLORI �' STATE OF FLORIDA r r COUNTY OF � � COUNTY OF Swo to (or affirmed) and subscribed before me of Swor o (or affirmed) and subscribed before me of this-Zby ,cal Pre e or Online Notarization y of 202V by Phy 1cal Pregeaae or Online Notarization thi--stayy of A_v, eLV 202 by aj1fi�T� n d�w Name of person making statement. Name of person making statement. Personally Knovrn OR Produced Identification tr/J Personally Known OR Produced IdentifiS Type of Identification \\\t1111Eiil SABRIry,���f'ii� Type of Identification \\\\ Pro ced �\\\N\ Prod ced • •• ���gRugRf��-�9c, � � F�o,RU,��y y- �'� ,, (Signature of Notary Public- State of Ff gdi�) s N SSignature of Notary Public- State of FEK� 4. 6-aY"V4e � z�9$s (36 ag639W � Commission No. °�e 2 ; : SABRINAL. BLACK d��(,'6%��ae`u� ' ,commission No. rhr SABRINA L. BIwACi� i��� ''ryrle ritecs fit` REVIEWS FRONT �rr OF t=G�... ZONING i/'Jfal;l'S0R PLANS VEGETATION `:s' SEA TURTLE � � k FL • `4,,�yt MFOVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED i DATE COMPLETED eV. 5