HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MIDST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
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
PERM iTTYPE: tt.LLb, it?oa 000fl-,
Address:g(elp
Property Tax ID#: 0 0(7—0 QQ Lot No.
Site Plan Name: (YY)Il—CZ;LP&LO fit-'tel'' ' Block No.
Project Name: �c►�}
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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: Sq.Ft.of First Floor:
Cost of Construction:$ ) Utilities: _Sewer _Septic Building Height:
Name_ -Jb Name:JAMES D.DAVIS
Address:9101 D 1Ch10U.'l 00 b1-Ar)5 Company:J&G CARPENTRY, INC.
City:S2�,- l C..er, State:Be Address:13461 79TH CT.N.
Zip Code: Fax: City: WEST PALM BEACH State:FL
Phone No. 14 (:4';32 -79:19 Zip Code: 33412 Fax: 561-855-4054
E-Mail: Phone No 561-855-4052
Fill in fee simple Title Holder on next page(if different E-MaIIf'-22� rz�c -sz t r'nn mlpl=l= c-O
from the Owner listed' above) State or County License 0881
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 COMPAW: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
M0 W'M
Applicable MORTGAGE COMPANY
Na e.
m
Address:
es
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 is in conflict with any applicable Home Owners 00ciation rulesi 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.
Thefollowing 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 Y03JR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
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Signature0f ownertYessee/contract.or as Agent for Owner Signkdti-of Contra ctor/License Holder
STATE OF FLORIO , STATE OF FLORIDA
COUNTY OF e_,A ' _W!' ' COUNTY OFPALM BEACH
The forgoing instrunt as acknowledged before me The forgoing instrument was acknowledged before me
this day of 20,)o by this ? -day of 20_Zoby
V� JAMES D.DAVIS
'Mme of per's-on making statement. Name of person making statement.
Personally Known OR Proquced Identification V Personally Known X OR Produced Identification
Type of I ntifica ion Type of Identification'
Produced Produced
ppm` rlan TNo
Stato Qf Flodrin
(Signature of Notary ob Expires 08/13/2022 (Signatdre of Nota r§Public- ate of Florida)
ff �'?'y ANGELAYOUNG
Commission No. t Commission No,GG 195361
(Seat) Commission No. ip aQornmission#GG0W8 6 ,
',A 'A" Expires April 12,2021
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Bonded Thru BudgetNotary Seffiu
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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DATE
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