HomeMy WebLinkAboutFitzpatrick - 115 Queen Bess Ct SLC All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��� �d9) Permit Number:
r 3.7
sW111
y'4:...`" Building Permit Application
Planning and Development Services
Building and Corte Regulotion 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 L CATION:
Address: IL5 LA ee__n L ; >Lw U
Property Tax ID#: -7n - noaI Lot No. (_
Site Plan Name: Block No. C*.__.___
Project Name:
D AILE.D D SCRIPTION OF WORK:
GUvi
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New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Addi al work to be performed under this permit-check all that apply:
tiiZMechanicall _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: $ 7 qU, Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: , CONTRACTOR:
Name Name:James Snyder
Address: ta9_ Company:5nyder's Cooling and Heating, Inc.
City; State: Address:P.O. Box 2007
Zip Code: _ � q Fax: City, Fort Pierce State:FL
Phone No. �'
- q - Zip Code: 34954 Fax: 772-600-4811
E-Mail: �" Phone N0772-528-3377
Fill in fee simple Title Holder on next page(if different E-Mail snyderseooling@aol.com
from the owner listed above) State or County License CAC1816579126414
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.
SUPPLEMENTAL CONSTRUCT. LIEN LAW INFORMATION:
DESIGNER/ENGINEER: J Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicabie BONDING COMPANY: � of Applicable
Name- Name:
Address: Address:
City: City:
Zip: Phone: Zip: Prone:
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,wails, 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 n attorney before commencing work or recording your bk&tice of Commencement.
ig ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA J r
COUNTY OF LI-A_L4 k, COUNTY OF i L—y-L4 C,
Swot, to(or affirmed)and subscribed before me of Sword to(or affirmed)and subscribed before me of
iO Physical Presence or Online(Notarization 1 Physical Presence or Online Notarization
this. day of 12020 by this day of ,2a20 by
J � 5� � �w� I
Name of person making statement. Name of person making statement,
Personally Known V-1,"OR Produced Identification Personally Known � OR Produced Identification
Type
of Identification `ced `����`�,t,SABRI���1ipi Pape of elddentification `�`ae\e��a��SARR�
:� °nrrnrssF •.�. �� e yconnh��ss �
F�aRuq�,��,•�' � � ��FEB�ttq�,oti�.
(Signature of Notary Public-State of Fl+ i }z ` (&nature of Notary Public-State of Flors�8 o � �m
• 0 • 4 'QL� G,�B w cn
Commission No. ° 2�y�U2 c mmission INo.6G u D��� f
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REVIEWS FRONT ZONINGif1f3L# �Slt PLANS VEGETATION SEA TURTLE ( t ® `
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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