HomeMy WebLinkAbout5514 Buchanon WH appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. 1 l Permit Number:
Building Permit Application
Planning and Development Services
Building and Code regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1.578
Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: - . Ck �� y` 4-- L- C
Legal Description:.,-'":
Property Tax ID #: C,, ,e::;[ - ._. Lot No. " C
Site Plan Name: Block No.
Project Name:
Setbacks Front I Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
A oItiona woro rmun er t is permit = c ec a app y:
HVAC Gas Tank Gas Piping ,shutters Windows Do
ors
a ,
Electric ®Plumbing OSprinklers 0 Generator E]Roof Roof pitch
Total Sq. Ft of Construction:
Iq
Cost of Construction: $ '1_0!75_0
l
SFt. of First Floor: _
Utilities:Sewer Septic
OWNER/LESSEE:
Name t.i
Address: �j 1
City: r V _ State7.
Zip Code:Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
CONTRACTOR:
Name: JOSEPH TULLY
Company: GENESIS PLUMBING SERVICE INC
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
City: POEN ST LUCIE State: EL
Zip Code: 34952 Fax: 772-335-2680
Phone No. 772-337-3682
E -Mail: GENESIS PLUMBINGSERVICES a@GMAIL_COM
State or County License: CFC1429103
If value of Construction is $2500 or more, a RECORDE[� Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip Phone:
BONDING COMPANY:
Name: _
Address:
City:_
Zip:
Phone:
— Not Applicable
State:
Not Applicable
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 OWNED: 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 recording our Notice of Commencement.
Signature of Owe - see Contractor as Agent for Owner
STATE OF FLORIDA,--,,, STATE OF FLORIDA
COUNTY OF -T COUNTY OF ` L
., .,
The f r ging instrum. nt was acknowledged before me The forgoing instrument was acknowledged before me
this sday of t% 20 IlDby this -L�, day of ! 20 by
(Name of person acknowledging) (Name of person acknowledging)
iSignat-ur Notary Pub{ -State of Florida) '
Personally Known;;R*'% { Pr A }y� Z^
Type of Identificati Commission # GG 971 50
ommission x u
°;,;`* Aprl 2d 2021
Commission No
Revised 07/15/2011
(Signature of Notary Public State of Florida)
Personally Known "'+lR Prcg44MpigAe ANie tQ)�fz
Type of Identificati t o i 'i Commission # GG 97150
=x c
rv, ? my Commission Expires
Commission No. Aprll 021
REVIEWS
DATE
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
COMPLETE
INITIALS