HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I 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:
7777
Address:
Legal Description:
Property Tax ID #: ID -
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No. i
r)
c�A�oc t1ie-d
of
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name
Name: JOSEPH F TULLY
Additional work to b erformed undeFfli
F_1HVAC
s� permit— �Pt_— check
all that app V:
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
LJ Gas Tank
F]Gas Piping
City: PORT ST LUCIE State: FL
Shutters
Windows/Doors
FlElectric Plumbing
Sprinklers
Generator
Roof
Roof pitch
Total Sq. Ft of Construction:
State or County License: CFC1429103
Scl. Ft. of First Floor:
M_ 7
Cost of Construction: $
Utilities:
Sewer Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: JOSEPH F TULLY
Address:
Company: GENESIS PLUMBING SERVICES INC
cit: State:
Y:
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
Zip Code: Fax:
City: PORT ST LUCIE State: FL
Phone No.,
34952 772-335-2680
Zip Code: Fax:
E -Mail:
Phone No. 772-337-3682
Fill in fee simple Title Holder on next page if different
E -Mail: genesisplumbingservices@gmail.com
from the Owner listed above)
State or County License: CFC1429103
It value of construction is $ZWU or more, a KtLUKLJtL# IMUL11-C Via ul [I' I— — . -I - .
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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.
rte: .r""`- �",.�- ^^.�-"-'." ••^�"��r�"_,.:�,v+v3 "°-��.. �,,..- _ - _
KiTnature of Owne6l Contractor as Agent for Owner _ ignature of Contra ctdr/License dlder
STATE OF FLORIDA,-,, , I STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgFing instrument was acknowledged before me
this day of 20 _by
(Name of person acknowledging)
E � �
(Signature of Notary Public- State of Florida)
Personally Known"
Z
Type of Identificati commission # ,G 971 'o
ommrssron x it
Aprl
Commission No. °;
�,,;24 2021
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this day of 20 by
(Name of person acknowledging) 4�
p-,
"(Signature of Notary Public- State of Florida)
— --gip
Personal) Known - ,_" ,
Y �R Prq{;,�p�eil�t�Tedi4lf�Z
Type of Identificati A°o `fid Commission # GG 97150
:* -
�. My Commission xprres
%''�orFti� April 021
Commission No. '���, ,,,o
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
BAS
( -1 10,34 1
In
2S
C -As
(FJO )
9
1`41
i�ront
EntrIt.
V, at
23 N r
-on
Locat'i
Mud Room Entry