HomeMy WebLinkAboutBuilidng permit application, SKYLIGHTS ONLYAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: — Permit Number:
•
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
PERMITTYPE:
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PROPOSED IMPROVEM NT L ATION:
Address: V4jQ h A I
Property Tax ID #: 1`"1I `-i " (®G�J- '(D�'� %��� 7Cx"J�.3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
n ._\� +' � C., �l � J�4 �� ^ih� [ Fin Ci)r"r� M, 1ufl�2.cQ� �1--- _ ��� �;�>• �,
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas 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: $ r aA Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE: i CONTRACTOR:
Name Y o - �" �� c�"ti`'��'' Name: 3AMES E REYNOLDS
i
Address: A (A 4 i I i Company: CORAD INC
i
City: R � State: FI Address: 2771 VISTA PKWY STE F11
Zip Code: '�;i-i q(4 9 Fax: City: WEST PALM BEACH State: FL
Phone No. J-I"�- c((o�' �lo�J� Zip Code: 33411 Fax: 561-771.0049
E-Mail: i ,-_n MiSc"W(r, Phone No 561-771-0047
Fill in fee simple Title Holder on 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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGN(:
Name:_
Address:
City: —
Zip:
NGINEER: - Not Applicable
Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:_
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:
BONDING COMPANY
Name:
Address:
City:
Zip: Phone:
. Not Applicable
State:
_Not Applicable
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH WUR LENDER OR AN. ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signa re of Owner/ Lessee/Con Victor as Agent for Owner Sign a re of Contractor/license Hol
STATE OF FLORIDA
COUNTY OF PALM BEACH
The forgoing instru nt was acknowledged before me
this I- day of 20 ; ,-� by
JAMES E REYNOLDS
Name of person making statement. /
Personally Known OR Produced Identification
Type of Identification
Produced i Notary Public State of Florida
714tJ
N—Rebecca E Stephens
My Commission GG 958848
Expires 0211612024
(Signature of Notary Public- State of Florida )
Commission No. (Sea!)
I REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
STATE OF FLORIDA
COUNTY OF PALM BEACH
The forgoing instrurrigint wa§ acknowledged before me
this I q day of , 20_Li by
JAMES E REYNOLDS
Name of person making statement
Personally Known K Nr a c e iaenuncauon M
ype Of Identification �r Notary Public State of Florida
roduced �PL— 4P AN -Rebecca E Stephens
My Commission GG 958848
e 1 a ad` Expires 02J W2024
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
SUPERVISOR I PLANS , VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW I REVIEW REVIEW I REVIEW