HomeMy WebLinkAboutBuilding permit applicaiton�i,-J"
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
•
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Building Permit Application
Commercial _______ Residential =
J PROPOSED IMPROVEMENT LOCATION:
Address: 3L3D 3{
S � � � Lot No.
Property Tax ID #: 3 �e l Block No.
Site Plan Name: a c. re- e,
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical _Gas Tank _ Gas Piping —
Shutters
Electric
Plumbing — Sprinklers _ Generator
_
Total Sq. Ft of Construction:
Sq. Ft. of First Floor: _
C�� lac-(,�� Utilities: _ Sewer _ Septic
Cost of Construction: $
OWNERXESSEE:
N a m e B LL Son LK ::N(C,. C1 Gce� n
Address:
City: -PC)c t �� �- State:
Zip Code:3`�a Fax:
Phone No. I 'la- (.2
E-Mail: C2PF'1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
4/-W indows/Doors
Roof Pitch
Building Height:
Name: JAMES D. DAVIS
Company: J&G CARPENTRY, INC.
Address: 13461 79TH CT. N.
City: WEST PALM BEACH State: FL
Zip Code: 33412 Fax: 561-855-4054
Phone No 561-855-4052 —
E-Mail
State or County License CGCO22831
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:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City:
State: City: State:
Zip:
Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable BONDING COMPANY: _Not Applicable
Name:
Address:
r itv•
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
WITH YOUR LENDER OR A ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
re of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 4, _r I � uCl
Thi forgping instrum nt was acknowledged me
thistday off_, 2 by
Y4 T, Sn,n G
Name of person making statement.
Personally Known OR Produced Identification
Type of Identificatign
Produced
v�
Signatur ontractor/License Holder
STATE OF FLORIDA
COUNTY OF PALM BEACH
The for oing instrumen was acknowledg d before me
this day of v 20�j by
iennGc n nAVIR
Name of person making statement.
Personally Known X OR Produced Identification
Type of identification
Produced_
Si nat e of Notdry Public t�f FloridaAINGELAYOUNG
(Signature of Notary ubli ( g =ot,;A f
MICHAEL McHALE Coj�►nis �n # GG 968864
Commission No. MyCO��ION�GG168796 Commission No. ` ae L�'peir� Apri112,2024
'1>1 o EXPIRES December 17. 2021 91_10FF��P` Bonded Thru Budget Notary Services
REVIEWS FRONT I ZONING SUPERVISOR PLANS =VEGETATIONSEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEWREVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED