HomeMy WebLinkAboutBuilding Permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: iLc ` Permit Number-.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578 COt7l1'1'lercial
Residential
Address: Yti` ,� 7-1 Ig 3
Legal Description^ 1--- '{ ` -': LuT —Q--t)
Property Tax ID #. Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional wor to e oerforme under this permit — c ec a a app y:
0HVAC Gas Tank F]GasPiping _Shutters Windows/Doors
nElectric Plumbing ElSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ co`—_-n . l) C o
Sq. Ft. of First Floor:
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE
CONTRACTOR:
Name W\
Name: JOSEPH FTULLY
Address: 0�;>-'�5 lz�'e7
City: State: I�
�'f�'�.—..�.I ���{.' '"t"
Zip Code. ��� Fax:
Phone No.
Company: GENESIS PLUMBING SERVICES INC
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 if different
from the Owner listed above)
E-Mail: genesisplumbingservices@gmail.com
State or County License: CFC1429103
If value of construction is $2500 or more, a RECORDED Notice or Lommencemenr is requires.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER; _ Not Applicable
Name: _
Address:
City:
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:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
State:
Not Applicable
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.
Signature of Owner/k see"%Contractor as Agent for Owner gnature of Contrac— t&/L-icense'-Ffolder
STATE OF FLORIDA,,.- , STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledge r� €More me
this of � 20 Lby
D_ i
(Name of person acknowledging)
(Signature of Notary Publrc-- State of Florida } " el
Personally Known - . ,.
Type of Identifitati Aprl 24 2D21 Commission # GG 97150
's, y ommIssFon .cpi
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Commission No. °j"'"'°�
Revised 07/15/2014
The forg ipg instrument was acknowledged before me
this f 'day of '� k \M . 20 1(- by
(Name of person acknowledging }
ature of Notary Public- State of Florida )
Personally Known
.,,>�:R Prgj�p�iei1�I�Tedi4�l=z
Type of Identificati°o °d commission # GG 97150
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a 1Z My Commission Expife
,`a0 M1�`o11 April 021
Commission No. f„ ,,,,
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