HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
µ Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 452.1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: I t i r",(- 6'
Legal Description:
Property Tax I D #: � � _ 413 . T
Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
kA
CONSTRUCTION INFORMATION:
Baa itiona wor to e er Dime under this permit— c ec a appy:
OHVAC f`` Gas Tank 0Gas Piping Shutters Windows/Doors
Electric l Plumbing Sprinklers 1:1 Generator E]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction. $ � t
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
` CONTRACTOR:
Name i'il (.i` (r
Name: JOSEPH FTULLY
Address:.__ _; :; . '`T° � ? fir- t
City: C+ °' State: Kij J
Zip Code: � l ' Fax:
. '5` - - t~
Phone No. ' � l � -� � �
Company: GENESIS PLUMBING SERVICES INC
Address: 3532 SE VILLAGE GREEN DRIVE UNIT B
City: PORT ST LUCIE State: FL
34952 772-335-2680
Zip Code: Fax:
Phone No. 772-337-3682
E --Mail
Fill in fee simple Title balder an 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 of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Address:
Name:
City:
Address:
state:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 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.
whichis iCounty
c onflicctt with anyappli ableEHome Owis ners Associationnting i rules, bylaws or andpcovenann s thto at maylrestrict ale 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, 1 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 nn -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.
mature of �wner(e/Contractor as Agent for Owner gnature of Contractor/License older
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF 4 ,- 4 s' COUNTY OF
The for,�*pping instrument was acknowledged before me
this , f?ay of LZA 20 %by
(Name of person acknowledging)
(Signature of Notary Publit- StateofFlorida
Personally Knownl, pr Ael�tl'frcG 97150 €�
Type of Identificati rJ Commission # G
%� y Omm�SSlo x P1
r;° „", Apr! 24 2021
Commission No.
Revised 07/15/2014
Thefro going instrument was acknowledged before me
this day of y� 20 ,2Q�by
(Name of person acknowledging)
of Notary Public- State of Florida )
Personal) Known : "",
,R Prq0vwA9$[eJ-ANiErJ6ftZ
Type of Identificati _ °o 3 Commission # GG 97150
a, My commission xpires
Commission No..
" April 221
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