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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number - Budding Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1558 Fax: (772) 462-1578 Commercial Residential x PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address:' +'� - `V U.f)aqF114, r Legal Description: {� ! -� 1�U' . Property Tax ID ##:� — --- ; — 1_Q r ytti _r Lot No. , Site Plan Name: _ Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: 61 rtiona wor to e er orme un er t is permit — c ec a HVAC M Gas Tank ❑Gas Piping Electric 1�j Plumbing Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ � c�r-� OWNER/LESSEE: apply: Shutters ] Windows/D©ors DGenerator l=J Roof Roof pitch SFt. of First f Floor: _ Utilities tSewer OSeptic Name ALP, r_ Address'' ire ct s' City: State: EL Zip Code: IS 0 Fax: Phone No. E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Building Height: Name: JOSEPH TULLY Company: GENESIS PLUMBING SERVICE INC Address: 1532 SE VILLAGE GREEN DRIVE UNIT B City: PORT ST LUCIE State: FL Zip Code: 34952 Fax: 772-335-2680 Phone No. 772-337-3682 E -Mail. GENESIS PLUMBINGSERVICES@GMAIL.COM State or County License: CFC1429103 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name: Address: City: Zip: Phone:. FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: — Not Applicable State — Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit Not Applicable State: Not Applicable wthichcis inconflic wimakth any applicable no iHomeat is Owners Associting a ation rules,ill aby bylaws or aize ndpcovenants that maydrestrctborrprohibit 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 your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recarding your Notice of Commencement. Signature of Owner. . see%Contractor as Agent for Owner gnature of Can#Tactor/License Folder STATE OF FLORIDA COUNTY OF' STATE OF FLORIDA -� e i COUNTYOF— The forgoing instrument was acknowledged hefore me this day of__ {1.- 20 (Name of person acknowledging } (5ign9tufe of Notary Pubircc- State of Florida) Personally Known fir;:*�� 1 Pr 6 RkJ z Type of ldentificati Commission # GG 97150 sv� ora y ommTssion x Aprl 24 2021 CorTimf55ion No. "r�a,nM Revised 07/15/2014 REV]EWS� FRONT ZONING COUNTER REVIEW DATE COMPLETE INITIALS The forgoing instrument was acknowledged before me this ti i day of _� 2p t °) by r^. (Name of person acknowledging) N, (Signature of Notary Public- Sfate of Florida } ` Personally Known ,++"r", + R Pr%*"ANoLejANi7rzLtWfZ Type of ldentificati °o €� Commission # GG 97150 =� = a. --My Commission xpares Commission No. /o;no' p,prjl 021 ERVIS S ANGRO RPViEWOR I EVfEW PLANSVREV1 W©N S REVIEW ATURLE M EVIEWVE