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HomeMy WebLinkAbout Building Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: D 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 X PERMITTYPE: PROPOSED )MPROVEMENT,lOCATIt)IV `` ' M t r T Address: 670-7 &_)0oD5(nK12,e7 LoiW _- Property Tax ID#: hJol—(QQ� d�j�'Z'.dp(���' Lot No. Site Plan Name: L1 =)oD Q�Y liftiT z YHL(4&x Lo%i y Block No. _ Project Name:_��Q-�/1 l7°�-w�yA C qc, 1 l h . DETAILED DESCRIPTIOIV'OF WORK �x J a x a cc- nc- ac. no sip cti�c, s i mRA ar COISTRE�CTION INFC►R )ATIN x5bbn0, r Additional work to be performed under this permit—check all that apply: _IVlechanical _Gas Tank _Gas Piping _ShuttersWindows/Doors '.:Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total�,q. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$�� .J, � Utilities: Sewer Septic Building Height: `0 LESSEE' Nam}e���/t�o�-��FLV�[yI. Name:JAMES D. DAVIS Address: tA2C�'i'L B�7 � Company:J&G CARPENTRY, INC. City:: �IfLr PIS _ State:AR-L- Address:13461 79TH CT. N. Zip Code: 51 Fax: City: WEST PALM BEACH State:FL Phone No.`I7Z 469 20910 Zip Code: 33412 Fax: 561-855-4054 E-M�II: Phone No s61-896-4052 Fill in fee simple Title Holder on next page (if different E-Mail C rnni �ay.�� l?4 from�the Owner listed above) State or County License CGCO2283 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If values of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. F . 31 ` V 5U Nl= PLElEtTALCON Wx 7Tt1( N ,.la` .� DESIiGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City:' State: City: State:' Zip: Phone Zip: Phone: I 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 the permit holder to build the subject structure which i5 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 consl,'Oeration 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 folibwing 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 YOURPAYING 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." I' Signature of Owner/Lessee/Contractor as Agent or Owner Signatur Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF E COUNTY OF--BEACH The f j oing instrument as acknowledged before me The forgoing instrument was acknowledged before me this day of 20`P by this day of 20 by .1 t' a e �. JAMES D.DAVIS Name:of person making statement. Name of person making statement. Pers n lly Kn wn OR Produced Identificati Personally Known X OR Produced Identification Typ o'f Ide i cati Type of Identification Pro u'ced ` Produced 3 h , ( nature of Public (Signat a of Not,ry Publi State of Florida) !. °1►AY P�''• WILLIAM LONNIE BLAKE ru '; ,•o �a tog a ANGELAYOUNG Comm'issia N ir•' �) %o*)Public•StateofFlorida ommission No. Commissiotb P68864 Commission k GG 929988 N� , Expires AOI 12,2024 My Comm.Expires Jan 28,202 s �o :I747 0 REVI, W5 FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE;-: RECEIVED DATE" COMPLETED ev. 3 I I ' r-LOPJIDA JURAT FS 112.05(13)—Effective January 1,2020 State of Florida county ofG Sworn to(or affirmed)and subscribed before me by mea GOT hysical Presence, • —OR- 0 Online Notar Mation, this 0-0 daayof ` ,aw d 6 'y Day Year Blame of Person Swearing crAttirming Signature a �-Jotary Pubt —Stag of Florida �ne�le-- V6'0 nle Name of AAvary Typ d,Printe Stamped 1 Personally Known =o,�pgYP(/BGc ANGELAYOUNG Prod Identification Commission ii GG 968864 pow Expires April 12,2024 9J�OFe1.°P\ Bonded Thru Budget Notary Services Type of Identification Produced: solace.Votary Seel Stamp above OPTIONAL of !n-this � f rm � r Y er• o f 1' LOrT,.:21..y u.iS it?;O,r.r�tii7i!Ca'J $:L'. Ci: .L7tl 7^vf:nE GfGC::,','larj or frC:u'uul=i=:i rta`i.'.`7CfirRe;'i Gf 2;.'ti5 tCrrfi to an U firs.`cr?d2d document i Description of Attached Document Title or Type of Document: 1 DOCUML-Rt©ate: __.Number of Pages: , I Signer(s)Other Than Named Above: � 1 02019 National Notary Association