HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
,.. Building Permit Application
Planning and Development Services
.Building and Code ,Regulation Division
2.300 Virginia Avenue, Fort Pierce FL 31982 �
Phone: (772) 462-2553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: (� c r l_-
Legal Description:
Property Tax ll7 #: Lot No.
Site Plan Name: Black No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work toeperformed under tis permit — 0eck all that appy:
j
HVAC I1 Gas Tank ElGas Piping Shutters Windows/Doors
Electric 0 Plumbing OSprinklers LJ Generator Roof Roof pitch
Total Sq. Ft of Construction:( S. Ft. of First Floor:
Cost of Construction: $ Q • Utilities:cnSewer F—ISeptic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: JOSEPH F TULLY
Address:
Company: GENESIS PLUMBING SERVICES INC
City: State: M`.)
Zip Code:. n(1 Fax:
Phone NO(sa
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
E-Mail:
Fill in fee simple Title Holder on next page i if different
E-Mail: genesispiumbingservices@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:
FRONT
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
REVIEW
Zip: Phone:
FEE SIMPLE TITLE HOLDER: z 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 1 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
commencin work ar recordin our Notice of Commencement.
.,,,,.�`v-• � 5� ted' t---�-T�.�.T.,_r.- -- -
STgnature of Own ex%L-essee%Contractor as Agent for Owner
STATE OF FLORIDA . STATE OF FLORIDA -,
COUNTY OF - G COUNTY OF
The nr'ng instrum nt was acknowledged hefore me The faoinginstrum - t was acknowledged efore me
this a r of 26 L this �,� V day of s t 20 by
g - i r(Name
(Name of person acknowled rng) [Nam e of person acknowledging )
(Signature cif Notary Public- State of Florida }
%�Wr
Personally Known . 0 ..Rro�,R Pr�I�pl���irZ
Type of Identificati ' eel Commission # GG 871 50
+a t v ommusslon Commission No. ,°i"` Aprl 24 �Q21
Revised 07/15/2011
(Signature of Notary Public- state of Florida) `
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fType oIdentificato
' d commission # GG 97150
My Commission xpire
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Commission No. ~"%`,9;'`+April 021
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