HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C1 I AA 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 LOCATION:
Address: d 5 i!/l� 00 lr t = 1 ��G�. �- 1 u,
Property Tax I D #: LJo7 s V61- DOA 9 - o Oc-) - - -- Lot No. n
Site Plan Name: Block No. 01
Project Name:
DETAILED DESCRIPTION OF WORK: I
P_e'v- Lk)
New Electrical Meter Second Electrical Meter
Lc9rNSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
vlio/echanical _ Gas Tank _ Gas Piping _ Shutters
Electric _Plumbing _Sprinklers
Total Sq- Ft of Construction:
DO
Cost of Construction: $ q,510®,
Generator
Sq. Ft. of First Floor:
_ Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNS LESSEE:
CONTRACTOR:
Name PX e.
Name:James Snyder
Address: r.
Company:Snyder's Cooling and Heating, Inc.
City; i State: E
Zip Code: _309 y-1 Fax:
Phone No. `1 Q - q 1.3
Address: P.O. Box 2007
City: Fort Pierce State: FL
1 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-Maiisnyderscocling@aol.com
State or County License CAC1816579126414
It 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 CONSTRUCTION. LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: k-' loot Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Z Not Applicable
BONDING COMPANY: of 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: 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 and sted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender o attorney before commencing work or recording our Notice of Commencement.
ignature of Owner/ Lessee/Contractor as Agent for Own
ignature of Contractor/License Holder
STATE OF FLO I A
STATE OF FLORID
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SABRINA L. BLACK sy'° e G�189_
SABRINA L. BLACK �„a'.-<°�aP s2
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