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HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� ` �:) Permit Number: .. .>F: ea Building Permit Application Planning and Development Services Building and Code Regulation Division 23001Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x PERMIT APPLICATION FOR: To Select from driapbox, click arrow at the end of line PROPOSED tMPRO'VEMENT LOCATION: _-_ Address: ':__ "1 l) ; C�e __ ,_r Legal Description: ._ [.t ' 1 �t'� '` ' '�C*� -'-; I � T� I '#,�(on d� I� Property Tax ID#: ''� `, ;; - - "t'� ;' -` Lot No. t Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: }Gl ut 1 (-I e k eC4 C'i C L I h n CONSTRUCTION INFORMATION: itional work to be ertormed under t ispermit-check all h apply: LJHVAC Gas Tank ❑Gas Piping En Shutters F-1 Windows/Doors Electric LJ Plumbing LISprinklers Generator ❑ Roof Roof pitch Total Sq. Ft of Construction: S . Ft. of First Floor: Cost of Construction:$ Utilities: Sewer I_mil Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name -�;_ _" Name: JOSEPH TULLY Addre (_' � r Company: j GENESIS PLUMBING SERVICE INC s, � ` - +, ti-rc�' � !,-.t� 's City: 4-t-,i-- 1-, ,iC',( State: F7L Address: 1532 SE VILLAGE GREEN DRIVE UNIT B Zip Code: ')vl Fax: City: PORT ST LUCIE State:FL Phone No. ���. `�C "' "',C 4` Zip Code: 34952 Fax: 772-335-26$0 E-Mail: Phone No. 772-337-3682 Fill in fee simple Title Holder on next page(if different E-Mail: GENESISPLUMB]NGSERVICES@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 required. SUPPLEMENTAL CONSTRUCTION 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: 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 our Notice of Commencement. Signature of Owne�Les~e/Contractor as Agent for Owner gnature of Contractdr/Licer+se bider STATE OF FLORIDA,_." STATE OF FLORIDA COUNTY OF �> COUNTY OF ` I The fgygoing instrument was acknowledged J�efore me The for ping instrument was acknowledged fore me this t� day of� �� 20 ''by this = °-- day of t't��.� .��� 2© by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Publit-State of Florida) '` (signature of Notary Public State of Florida ) Personally Known :.�<:���+' PrftRW#lCwfFC*PAZ Personally Known ",°: Pr�mAW%e ANkAtQ Z Type of ldentificati Comrrissian#GG 97950 Type of Identificati =_#+o; Commission#GG 9795 Y om i$slon xpi � r= My Commission xpare 9f °��" Apr1 24 Z021 °,�i�„i .` Aptll OZ] Commission Na. Commission No. Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS