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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: j C) Permit dumber. Baallding PermR 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: Address: CY.7 i 0 �- 0 n-dA r' _ )_ r� ,•r I— ?� Legal Description: ` ©—�� L tJ �m A Property Tax ID #: � � ��` - �b� - �( - Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK:. i CONSTRUCTION INFORMATION: Additional wo—rk to b nGasTaflk r orme un er t is permit- c ec a t app y: OHVAC Gas Piping M_ Shutters E3Windows/Doors 7 Electric [I Plumbing Sprinklers ElGenerator F]Roof C] Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ Sq. Ft. of First Floor: Utilities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name J� Name: JOSEPH F TULLY Address:_ ,� E((-r _ Company: GENESIS PLUMBING SERVICES INC : City State: �� lit'-��i�.._. Zip Coder by Fax: Phone No. Q -" 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: k�rnAA hl Fill in fee simple itle Holder on next page ( if different from the Owner listed above) E-Mail: genesisplumbingservices@grnail.com State or County License: CFC1429103 If value of construction is $2500 or more, a RECORDED Notice of commencement is requires. SUPPLEMENTAL CONSTRUCTION LIEN LAVA INFORMATION: DESIGNER/ENGINEER: Name: _ Address: City: zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: Not Applicable MORTGAGE COMPANY: _ Not Applicable State — Not Applicable Name: Address: City: State: 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 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 our Notice of Commencement. f_e Jam" _.-.Y,-.� .�'^'✓-.✓'�� rT,w _. ,Signature of Owner] seefContractor as Agent for Owner gnature of Contra ctdr/License FFdIder � STATE OF FLORIDA.- , I STATE OF FLORIDA COUNTY OF .`�.=fd COUNTY OF The frgo'nVnstru rt was acknowledged 4efore me this" ay of _ i 20 £n by (Name of person acknowledging } (Signature of Notary Public- State of Florida) Personally Known ,.,,:aTu%t Prtlel�'tfilZ Type of Identificati ' Commission # GG 971 50 Y e y ommission R Commission No. Revised 07/15/2014 The forgoi2 fnstru ent was acknowledge efore me this day of 20 1 by �J (Name of person acknowledging) {Signature of Notary Public- 5tate of Florida } `' Personally Known - ++ °;R Pr Z� �dp�lelffliEdiGk}i 4 Type of Identificati °o `"'�J Commission # GG 97150 =,y My �'•"�' Cammissionxpie 02ij Commission No. AprE REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS