HomeMy WebLinkAbout13525 S Indian River Dr unit 103ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� 1'� �� �� 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
Address:
Legal Description:.
Property Tax ID #: `J ` + — Lot No.
Site Plan Name:
Project Name: _
Setbacks Front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Block No.
CONSTRUCTION INFORMATION:
Additional work toe er orme un er t is permit— check
El
a at appy:
❑_ HVAC Gas Tank E]Gas Piping
Shutters Windows/Doors
IJ Electric LJ Plumbing EjSprinklers
Q Generator Roof Q Roof pitch
Total Sq. Ft of Construction: #
#
Sq. Ft, of First Floor:
0Sewer Height:
_
Cost Utilities:
Cost of Construction. $—
L �.lSeptic Building
OWNER/LESSEE:
CONTRACTOR:
Name 17 A_` -F
Name: JOSEPH FTULLY
Address- ' R 0.i�`` ,
Company: GENESIS PLUMBING SERVICES INC
City: -� �' { State: �V.
Address: 1532 5E VILLAGE GREEN DRIVE UNIT B
Zip Code: Fax:
City: PORT ST LUCIE State: FL
Phone No. ° iL'; ~ ' i
Zip Code: 34952 Fax: 772-335-2680
E -Mail:
Phone No. 772-337--3682
Fill in fee simple Title Holder on next paged if different
E-Mail:genesisplumbingseavices@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
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 thepermit 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 pians, 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
commencin,Q work or recording vour Notice of Commencement.
-
Signature of OwneT71�seeJContractor as Agent for Owner
STATE OF FLORIDA,
COUNTY OF e _
The forgoing instrument was acknowledged hefore me
this ri day of_ . A,, 20 by
(Name of person acknowledging)
(Signat&6 of_Notary Pubii'c- State of Florida) "
y r it r' y,8eifflicz r Z
Personall Known
Pr
Type of Identificati Commission # GG 97150
y omm+s�2.2,��
r°„"�°� A¢7rl 2
Commission No.
Revised 07/1512014
STATE OF FLORIDA
COUNTY OF.�'`
The for i,ng instrument was acknowledged before me
this day of_ -`� i, l 120 1 by
(Name of person acknowledging)
(Signature of Notary Public- Siate of Florida) '
Personally Known
Type of Identifieati _ °o d Commission # GG 971.
My commission •xPire
or ARrit 021
Commission No. +rnr it
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