HomeMy WebLinkAboutBuilding Permit Applicaiton-SKYLIGHTS ONLY All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �] �
Date: �+' �� Permit Number: X1'0 ' 0 l!�-
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Building Permit Application ell.�go� ?°1®
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 TYPE:
PROPOSED'IMPROVE EN .LOCATION.
Address: g l '
Property Tax ID#: oCX7 Lot No.
Site Plan Name: Block No.
Project Name: l
SDE-TA]L'•ED`DESCRIPTION OF.INORK
Par I.;ke_
a►onjQn-C-JC jj
_`CONSTRUCTION INFORMATION
Additional work to be performed, under this permit-check all that apply:
_Mechanical _Ga`s Tank _Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ sSU. Utilities: —Sewer —Septic Building Height:
.'OWN,ER/LESSEE:. : CONTRACTOR: _
Name Name: JAMES E REYNOLDS
Address: A_Ar_urA6, Company: CORAD INC
City: Fnr� `��e�c _ Stater Address: 2771 VISTA PKWY STE F11
Zip Code:3�9ga Fax: _ City: WEST PALM BEACH State: FL
Phone No. -77';- 5�S-Oen Zip Code: 33411 Fax: 561-771-0049
E=Mail: Phone No 561-771-0047
Fill in fee-simp a Title Holder n next page(if different E-Mail REBECCA@PERMITGROUPFL.COM
from the Owner listed above) State or County License CGC 054348
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTI NUEN LAW INFORMATION
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: =Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 thepermit 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sign ure of Owner/Lessee/Cont ctor as Agent for Owner Signatur6 of Contractor/License Hold
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this La_day of 0%2by this !D- day of P 4I 20 ZU by
JAMES E REYNOLDS JAMES E REYNOLDS
Name of person makings,atement. Name of person making tatement.
Personally Known V OR!Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
r�
(Signatur of Notary Pubiic- ate of Florida) (Signature of 4otary Publi ate of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
s �'P�•, MITCH BOCOOK 3'o'g�'P�EMF
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NotaryPublic-StateofFlorida °•: Notary Public-State of Florida
`• ' ` •' Commission#GG 015422 '• _ Commission#GG 015422
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' OPF1'O� Bonded throughNatianalNo[aryAssn. ^•.�,,,�••`' Bonded through National NotaryAssn.