HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
7
Fru M
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FC 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential X
Address: 1, 00LL"-'t, S QC Dc',, ¢, �Jn�� � dO�
Property Tax ID #: yJ Q a _ 5 Oy " 00; i! - 000 G Lot No.
Site Plan Name: JC1Me s 0z� bC Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: i
C kcn J 1 +_
6 V -t -', Nn- r1p O'..,� "�' F
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters Windows/Doors
Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ _ i L4 ('C'
Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:-
CONTRACTOR:
Name S Oc PQ..V i
Name: JAMES D. DAVIS
Address: i nnU 4 ( zO,n 11c un A l a0G
Company: J&G CARPENTRY, INC.
City: State: E_L
Zip Code: '� c-iQj"7 Fax:
Phone No..7 S7 -elf? �s�9
Address: 13461 79TH CT. N.
WEST PALM BEACH FL
� City: State:
Zip Code: 33412 Fax: 561-855-4054
Phone No 561-855-4052
E -Mail,
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail
State or County License CGCO22831
If value of construction is 52500 or more, a RECOKDEL) Notice or Commencement is requires.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 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
wIITU YOUR LENDER OR AN ATTORNFY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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l
Si ture of Contractor/License Holder
Signatur Owner/ Lessee/C tractor WAgent for Owner
STATE OF FLO IDA
STATE OF FLORIDA
COUNTY OF &- ac
COUNTY OF PALM BEACH
The forgoing instruff ent was acknowledged before me
The forgoing instrument was acknowledged before me
this szZQday of 2� by
this � day of f)9 20aQ by
h _ S c'c% JAMES
D. DAVIS
Name of person king s atement.
Name of person making statement.
Personally Known _X OR Produced Identification VI/
Personally Known x OR Produced Identification
Type of Iden ificatio
Produced(, �. t- '
Type of Identification
Produced
(Signat e of NotaN Public- t lqf FloridAkGELAYOUNG
(Signa re of No ary Publ, - � ,�f Floridy-�GELAYOUNG
r° � •••,� ° Commission # GG 968864
r° '"''• °
C�J fQ� #GG 968864
Commission No. * Q (jfojisApril12,2024
Commission No. * Eic�Ylpfi112,2024
I BONO Yhru B*4t Notary
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