HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; I ` y ,Ty Permit Number:
v
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
5
Address: ,� a�:�.r `� a �a
Legal Description: pp,:-
Property Tax ID #:Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side
Left Side:
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to e —pur orme under t ispermit — check all t t appy:
HVAC I _1 Gas Tank F_, Gas Piping _ Shutters windows/Doors
FlElectric Plumbing O Sprinklers FIGenerator Roof Roof pitch
Total Sq. Ft of Construction
Cost of Construction:
S.Ft. of First Floor: _
Utilities: U Sewer 17 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ,
Address:
Name: JOSEPH F TULLY
Company: GENESIS PLUMBING SERVICES INC
City: . _ 5 �, �- State: `=
Zip Code: , '�, r F Fax:
Phone No. �' 9� "� '1�`. - a _
E -Mail:
Address. 1532 SE VILLAGE GREEN DRIVE UNIT B
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax: 772-335-2680
Phone No. 772-337-3682
Fill in fee simple Title bolder on next page ( if different
from the Owner listed above)
E -Mail: 9enesisplumbingservices@gmail.com
State or County License: CFC1429103
It value of construction is $2500 or more, a RECORDW Notice or commencement is requireu.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE
Name: _
Address:
City: —
NGINEER: — Not Applicable
Zip: Phone:
FEE SIMPLE TITLE HOLDER
Name:
Address:
City:
Zip: Phone:
State:
Not Applicable
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 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.
m..
Signature of Owner/ seejContractor as Agent for Owner _ lgnature of Contracto'r/!Lirpn-P-RJ_Acnr
STATE OF FLORIDA, STATE OF FLORIDA
COUNTY OF COUNTY OF -
The forgoing instrument was acknowledged before me
this 1_-�dayof 20 -by
(Name of person acknowledging)
(Signature'of Notary Public- State of Florida)
Personally Known °.:aY";°� PrdAPdMA6aWIfbitmZ
Type of Identificati Commission # GG 97150
Commission No.
�., arc y amm�ssEon x �
;,;;,;,`1Apr1 24 202
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
The forgoing instrument was acknowledged before me
this ;— - day of 20 M by
(Name of person acknowledging )
ature of Notary Public- State of Florida )
Personally Known Pr
Type of IdentificatI Commission # GG 97150
My Commission xpires
Commission No. "°%`u4';,`,` d
Apr021
SUPERVISOR I PLANS I VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW I REVIEW