HomeMy WebLinkAbout5208 Plam Dr appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � � � 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) 462-1578
Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
aCl�.R;��,
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a app y:
Property Tax ID #:
--;
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L_I Generator Roof Raaf pitch
Lot No. l
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
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a app y:
LJ HVAC E Gas Tank ❑Gas Piping
0
_ Shutters Windows/Doors
Electric RI Plumbing Sprinklers
L_I Generator Roof Raaf pitch
Total Sq. Ft of Construction:
Sq. Ft. of First' Floor:
Cost of Construction: $ Utilities:
�Sewer i Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name 1 ', - -
!Name: JOSEPH TULLY
Address:1r-, -
-
Company: GENESIS PLUMBING SERVICE INC
City:, r< _V'i � ,.- State: 4— 1 -Address:
1532 SE VILLAGE GREEN DRIVE UNIT B
Zip Code: _ ) =_ Fax:Cit
: y PORT ST LUCIE State: FL
Phone No. r )f fes-; `� 1,, t e.
Zip Code: 34952 Fax: 772-335-2680
E -Mail:
Phone No. 772-337-3682
Fill in fee simple Title Haber on next page ( if different
E -Mail: GENES ISPLUMBINGSERViCES@GMAIL.COM
from the Owner listed above)
State or County License: CFC1429103
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requited.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
DESIGNERANGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
REVIEW
Zip: Phone:
BONDING COMPANY: Not Applicable
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 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 your Notice of Commencement.
Signature of Owner/leesz�e/Contractor as Agent for Owner rgnature of Contractdr/License Hdider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledgeri,hefore me
thiss.
_t - -day of 1,,-= — 20 �,by
(Name of person acknowledging) }
(signatGre of Notary Public- State of Florida) " r'
Personally Known �'pa!*"%' 3j Prddtl 6ah1tll# ;S Z
Type of Identificati Commission # GG 97150
3, gs` y ammrssion xpr
Commission No. ApN 2A 20
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this �I day of = I ..'r-, 20 .._'t by
!�__
(Name of person acknowledging )
Si nature of Notes J
( g Notary Public- Sate of Florida
Personally Known Pr A9AeJAI§Rdi4�i Z 11
Type of Identificati o `""i commission # GG 97150
E n
E My commission xpires
OF:L�;.`` April( 0 2 1
Commission No. ''n,. ,,,�
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