HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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:
Permit Number:
Building Permit Application
Commercial Residential X
Address: '2 &PC t �20>olC, j�j L-L) i
Property Tax ID ft: /L132 - S-Ul -- Lot No._��O:;L
Site Plan Name: SIB ;^T\ PuAZ-%A Block No.
Project Name: TI0 A
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: / 15
Cost of Construction: $ %,271-47
Name
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Address: '2_�-C?I T72-bPt G g L-V l�
City: FT _P I EjzcE State: r---
Zip Code: 3 qq,i4 I,p Fax:
Phone No. 77% gte4 5-7b /
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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.
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: — 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 malcateo.
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 W 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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signa a of Contractor/License Holder
STATE OF FLORIDA�,
STATE OF FLORIDA
COUNTY OF -_
COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me
The forgoing instru nt was acknowledged before me
this>�day of E 20 �by
this day of
26al) by
JAMES D. DAVIS
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known x
OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced_
(Signature of Notary Public- State
of Notary Public- tate of Florida )
i�Y: B •. MARIE HEM
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Commission No.6 CMG 1L09y
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:o EXPIRES: Janua
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3, 2021
Q Expires April 12, 2024
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Rev. 2/ I/ 19