HomeMy WebLinkAbout9087 Short Chip Cir permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: iQ ��{
Permit Number:
J;
- 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 X,
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:'CA 0 1 r .....—� L CL��
Legal Description:
—
Property Tax ID #: `�j — - - Lot No.
Site Plan Name: Block No. r)_
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRlPTIDN OF WORK:
I n 44�
CONSTRUCTION INFORMATION:
rtw jona or to e er orme under this permit— check all tat apply:
CIHVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric L11i Plumbing 05prinklers 12 Generator Roof Roof pitch
Total Sq. Ft of Construction: S�Ftj of First Floor:
Cost of Construction: $ J `�) Utilities: jJSewer E Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name - `
Name: J05EPH F TULLY
Address:
�(� ' I ��� �� p �'
Company: GENESIS PLUMBING SERVICES INC
City: L state: EL
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
City: FORT ST LUCIE State: FL
Zip Code: Fax: Fax:
Phone No.t`}
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
E-Mail: 9enesisplumbin gservices@gmail-com
State or County License: CFC1429103
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:
Name:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Address:
Name:
City:
Address:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY: Not Applicable
Address:
Name:
City:
Address:
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 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.
__ .� �"
=Signature of Owner/Le see7Contractor as Agent for Owner gnature of Contract r/License Mold&
STATE OF FLORIDA,,t,4 STATE OF FLORIDA
COUNTY OFF �, _ COUNTY OF
The forgoing instrument was acknowledged�efore me
s thiday of q�_ _, 20 fy_by
(Name of person acknowledging }
37ti 1
(Signature of Notary Publi'6 State of Florida
Personafly Known
Type of iderrtificati Commission* GG 97150
-]
? ; ,z My ommrssion x i
Commission No. Aprl 24 2021
Revised 07/15/2014
The forgoing instrument was acknowledged before me
thiOl day of 20 1 by
(Name of person acknowledging)
-(Signature of Notary Public State of Florida )
Personal) Known .»,"�!�
Y .�ti Prgd96lei t�il+�Z
Type of Identificati _ 'o `` Commission # GG 97t50
rvty COmmi..'On xpire
Commission No. %;;9"`,`` April 021
REVIEWS
DATE
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
COMPLETE
INITIALS