HomeMy WebLinkAboutBenson AppAll 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 X
PERMIT TYPE:
Address: 44612— TA1=:()n
Property Tax ID #: Lot No.
Site Plan Name:iT�ll1 r3� fl�i�i� Block No.�t�
Project Name: KACTM _66-76W
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: 9 2Q 7 Sq. Ft. of First Floor:
Cost of Construction: $ 5 :541oc 'T Utilities: —Sewer —Septic
Name �Ali 1,
Address: _4>� lZ
City: �T V►Ef2C� State:C–�---
Zip Code: :2 c4, Fax:
Phone No. �1 o2`i4�Fj
E -Mail:
Name: JAMES D. DAVIS
Windows/Doors
_ Roof Pitch
Building Height:
Company: J&G CARPENTRY, INC.
Address: 13461 79TH CT. N.
City: WEST PALM BEACH State. FL
Zip Code: 33412
Phone No 561-855-4052
Fill in fee simple Title Holder on next page ( if different I E -Mail
from the Owner listed above)
Fax: 561-855-4054
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
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
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 thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rule, 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."
Rev. 2/j/19
Signat6ile of Contractor/License Holder
Sign ure of Own /Les /Contractor as Agent for Owner
STATE OF FLORIDA'
STATE OF FLORIDA
COUNTY OF I— L�(���QJ
COUNTY OF PA --H
The for g instrume t was acknowledged before me
The forgoing instrument was acknowledged before me
tof 20Py
hi�?
this / 4 day of SLn.1�c=f 20 by
JAMES D. DAVIS
Name of person making statement.
Name of person making statement.
/
V
Personally Known OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
ProducedF L_0X31 313IgI
Produced
(Signature o Public- State of NOTARY PUBU
(Sign ure of Notary Pu Ic- State of Florida )
STATE OF FLOR
Commission No CornrnllGG29461
pA aY'u AJGELAYOUNG
Commission No. =°sP e,° �oemi�lsion#GG
Expires 2/17/20
968864
23 N ,' =;i ' T Expires April 12, 2024
<oF {�o Bondedliru
u 9e Notary ern
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/j/19