HomeMy WebLinkAbout5501 Seagrape Dr permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 i (q Permit Number:
Budding 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:
Address �7 J r (- `, r �� t1
Legal Description: t
Property Tax ID #: � �� L}\0 u Q Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION.:
1tiona wor to (eeer orme un er t 3s permit— c ec a at app y:
❑HVAC LJ Gas Tank ❑Gas Piping_ Shutters Windows/Doors
1-1Electric1K Plumbing [] Sprinklers 1 Generator � Roof = Roof pitch
Total Sq. Ft of Construction:
Sq. of First Floor:
7 Building Height:
Cost of Construction: $ Q Utilities:
L ,J Sewer Septic
OWNER/LESSEE:
CONTRACTOR:
Name,
Name: JOSEPH F TULLY
,� _ ` `
Address:��-
Company: GENESIS PLUMBING SERVICES INC
p Y-
Address; 1532 SE VILLAGE GREEN DRIVE UNIT B
Cit i (E: Stater
y= -
City: PORT ST LUCIE State: FL
Zip Cade: 0 Fax:
Phone No. ��
Zip Code: 3`tg62 Fax: 772-335-2680
Phone No. 772-337-3682
E-Mail:
E-Mail: genesisplumbingservices@gmaii-com
Fill in fee simple Title Holder on next page { if different
State or County License: CF01429103
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of
Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: i Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE MOLDER: _ 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 Horne 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, wails, 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.
Signature of Owner./ see%Contractor as Agent for Owner gnature of Contract r/Lice n sff Frdlder
STATE OF FLORIDA,_ STATE OF FLORIDA
COUNTY OF {�:� —°�_. R '_ COUNTY OF s E_jr
The fort ng instrument was acknowledgeri efore me
this oday of c J =1 20 by
(Name of person acknowledging )
('a
(Signature of Notary Publ'r State of Florida
"4461Nf„
Personally Known ;.,'.•Y•Qg Prddd&MhehPtfffc;i%tfZ
Type of Identificati { Commission # GG 9715
?�V, Z My commission Expires
?�fl`�� Aprl 24 2021
Commission No. ""
Revised 07/15/2014
The for goi g instrument was acknowledge efore me
this day of VL 20 by
(Name of person acknowledging)
(signature of Notary Public- 5fate of Florida j
PersonallyKnown ":';jdRPr",qOeJ7iMid
Type of Identificati - ° ` J commission # aG 97150
'*
t_ My Commission txplre
Commission No. `ya`,9','�°Apr11 i321
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