HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICAJBLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: al Permit Number:
0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial ReSIC(efitlal
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: 51 �F /�
PropertyTaxlD#:
Site Plan Name:
Project Name:
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0
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
ATC7
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New Electrical Meter Second Electrical Meter
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
vMechanical _ 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: $ .-k L4 0740 . QI Utilities: _Sewer _Septic Building Height:
OWNERJLESSI E:
CONTRACTOR:
Name-T, Mirha&Y-(-
Name:Jaynes Snyder
Address: c5to (J. 0141 Al k k- ! b4P
Company. Snyder's Cooling and Heating, Inc.
City: — ' kw C- State: r-1•
Zip Code: Li Fax: C��
Phone No. 7 . 353 f 10 vuu
Address: P.O. Box 2007
City- Fort Pierce State: FL.
Zip Code: 34954 Fax: 772-6004811
Phone No772-528-3377
E-Mail.
Fill in fee simple Title Holder on next }sage ( if different
from the Owner listed above)
E-Mail snyderscooling@aol.com
State or County License CAC1816579 / 26414
Ii eaIuz ue ;AJIV�LrucLIu" i5 L3uu Or more, a Kt;_V 1Jtu NOVCe or commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT N LIEN LAW 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: _ Not 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 acid 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 Horne 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 osted on thejobsite before the first inspection. If you intend to obtain financing, consult
with lender n attorney before commencing work or recording your otice of Commencement.
3
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nature of Owner/ Lessee/Contractor as Agent for Owner
gnat ire of Contractor/License Holder
STATE OF FLORI _
COUNTY OF �it-(�i
STATE OF FLORIDA
COUNTY OF
Swar to (or affirmed) and subscribed be€ore me of
5woyr�'o (or affirmed) and subscribed before me of
Ph sisal Prese r Online Notarization
this day of KLIX 202t by
✓✓ Ph sisal Pres _cg or Online Notarization
this � day of �YJIr U aN 202d by
ll e�
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type Prod o ed identification
�Elltliilll;t
�/fZ
� 15 � � oe�costiayssl�v
[.L.iI"� w SOVN -
(Signature of Notary Public- State of Florig'a j ; �4�0 ?�� ��•
Commission No.al �G289gd2osthmission
SABRINA L. BLACK ':yQ� y
REVIEWS FRONT ZONING ���`�:`�
COUNTER REV[EW PRVI Iffi
Type
Prod of Identification 0\k lal JJJJ
d
�r ��;� SarY{F�
( nature of Notary Public- State of Florid —
No./jY�(j� (v) 7 �, o�Aa� 9g�z
` SABRINA L. BLACK
PLANS VEGETATION SEA TURTLE iq Vo��e
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.