HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. Permit Number:
COUNTY
—_ -- 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:
Address: 5o210 1�a��c.0 LYIES CiY2L.LS
Property Tax ID#: 13 I o�L — ��l —dD£59 — —� - Lot No. PIAn
Site Plan Name: O�14-O L-A 9t v-1 ES Block No.
Project Name: r/�,Onni£ 'M-Cir-
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing
q _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ .S(AI S Utilities: _Sewer _Septic Building Height:
Name 1E ENCCILO/G LFS"E_JO"S Name:JAMES D.DAVIS
Address: 10 TPLj10 PtnCS C dLC L. Company:J&G CARPENTRY,INC.
city: F-r Pt&W.6 State: E— Address:13461 79TH CT.N.
Zip Code: 3401SI Fax: City: NEST PALM BEACH State:FL
Phone No. --7.7 2 2$S 1-4 SGS Zip Code: 33412 Fax: 561-8554054
E-Mail: Phone No 581-855-4052
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License CGCO22831
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
H value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
DESIGNE ENGINEER: x Nat 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 indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Counttyy 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 1 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 cancurienry 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 N 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/ tractor as Agent for Owner Signature Contractor/License Holder
COUNTY
STATE
OR FLORIDA-[(� COUNTYOF --
The for ng instrW}Rnent was acknowledged before me The forgoing instrurpent was acknowledged before me
this NW
2071 by this_3_day of FP.h. .2621 by
!to , /J)']t 0i .wines D.DAVIS
liflinfe—of person making statement. Name of person making statement.
Personally Known V OR Produced Idenofcauon Personally Known x OR Produced Identification_
Type of Identification Type of Identification
Produced Produced
(Signature of N o a ublic-Stat of Florida I (Signat a of No ry Public�State q��NfAqip) ANGELAYWNG
Commission No. Sea s•e ��•�Ra G0"�ma&0^T�98 4
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REVIEWS FRONT ZONING Ih f TATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
PLORLDA JURAT
PS 11705(13)—Effective January i.2020
State of Florida
County of PALM BFACH t
Swom to(or affirmed)and subscribed before me by
means of
X Physical Presence,
—OR—
❑Online Notarization,
this .f) dayof r-e ,.202l by
Day Month year
JAMES D. DAVIS
�Name of Person Swearing orAffimring
S nature Not ryP —StateofFlorida
AN(dFi A VOt1NG
Nome of Notary Typed,Printed or Stamped
„ar vet MGElavouNG M Personally Known
Commimm 8 GG%8064
Eepires April 12,2024 ❑Produced Identification
&Msvive 9W ril 14 202nirzs
Type of Identification Produced:
Place Notary Seal Stamp Above
OPTIONAL
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to on unintended document.
Description of Attached Document
Thle or Type of Document
Document Date: Number of Pages:
Signer(s)Other Than Named Above:
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02019 National Notary Association