HomeMy WebLinkAbout5310 Myrtle Drive permit appALL APPLICABLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
DatePermit Number:
.. Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 452-1S53 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax 1D #f:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side. -
L q6,Z)
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to e er orme un er this permit — c ec a apply:
�HVAC 0Gas Tank Gas Piping ffi_ 5hutters Windows/Doors
Electric MPlumbing Sprinklers El Generator E]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction:
S Ft. of First Floor: _
Utilities:cnSewer ESeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name l
Name: JOSEPH F TULLE`
Addres • � 1
Company: GENESIS PLUMBING SERVICES INC
City: _ State: k-
Zip Code: Fax:
Phone No. os)` "`
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax: 772-335-2680
Phone No. 772-337-3682
E-Mail: f "
Fill in fee simple Tine Holder on next page ( if different
from the Owner listed above)
E-Mail: genesispiumbingservices@gmail.cam
State or County License: CFC1429103
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone_
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of Own e[/ see%Contractor as Agent for Owner ignature of Contractor/LicensL-ff&fder
STATE OF FLORIDA,. STATE OF FLORIDA
COUNTY OF tiF` COUNTY OF
The forgc�ir in i nt was acknowledge before me
this � day of__ 2fly
(Name of person acknowledging)
(Signature of Notary Public- state of Floridan)
�i"Ri+
Personally Known 13 PrZ
Type of Identificati i&l Commission # GG 9715U
a y ornmission xp
`'%`°�n°�'�; Aprl 24 2021
Commission No. """+""'11
Revised 07/15/2014
The forg i inst t was acknowledgede�fore me
this day of 1 �C 20 -+ by
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known ",',fdi Prq 9AeJ-ANiVcdi4k�7
Type of Identificati o Commission # GG 971 50
My Commission xpires
Commission No. m 1 11 April G21
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