HomeMy WebLinkAboutBUILDING PERMIT 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
PERMIT TYPE:
',
Address: gQnu l),}9rTtWC)0 . Ln
Property TaxlD#: J3a4-CJV4--0CCL'-0M-6
Lot No.R'-zl_
Site Plan Name:
Block No.
Project Name: (TSM PPSMWIP
l,]innbp LL)ia 2MOOY
QC. D( n0 SiaP +k'-1'9Q
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank
_Gas Piping _Shutters X Windows/Doors
_ Electric _ Plumbing
_ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $1. �q 4P�. i�.
Utilities: _Sewer _Septic Building Height:
Name LTSi
Name: 1AMES D. DAMS
Address: LIl
Company:38G CARPENTRY, INC.
city:. L� I )riP
Stater Address: 13461 79TH CT. N.
Zip Code: Nq &3 Fax:
City: WEST PALM BEACH State: FL
Phone No. 4Qj - U
Zip Code: 33412 Fax: 561-865-4054
E-Mail:
Phone No 561-855-4052
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.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: x
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:_
City:
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
..... nnrrrvrrr.mppi¢anon isnereoy maoeto oorain a permittodotneworkand installation asindirated.
1 certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counpp makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con with any applicable Home Owners Association rules, bylaws or antl 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 concurrenry 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 RFCORDR IG Yri NnTWF nF rnumanxi Tr.
Signature of Owner/Lessee/Contractor as Agent for Owner
Sig reof Contrattor/License Holder
STATE OF FLORIDgg
STATE OF FLORIDA
COUNTYOF 1�. �1 cte
COUNTYOFP+ur—
The grgoing instrument w sacknowledged before me
this day of G�ntUo-r� ZO�by
The forgoing instrument was acknowledg beforeme
l�lar.
this [day of .z0 by
U$I
Fb.�'(�C.isa. IMh
. ESD. MVtS
Name of person making statement.
Name of person making statement.
/
Personally Known _ OR Produced Identification �[—
Personally Known x OR Produced Identification
Type of Identif55atiorL�
Produced �L L)rova La CCyYsG
_
Type of Identification
Produced
(Signature of NotaYy Public-
D(Signa
re Notary Public- Sta of Florida )
ybli�c-State /lamb Ixywl
Commission No. N i7cD4 J I• Naarypmnc sute
FIsnN
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Ion No. (Seal)
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
FLORIDA JURAT
F5117.05(13) — Effective January 1, 2020
State of Florida l
County of PALM BEACH 1`
Sworn to (or affirmed) and subscribed before me by
means of
M Physical Presence,
—OR—
❑ Online Notarization,
this / -� dayof1146 f-, -211211by
Day Month year
JAMES D. DAVIS
Name of Person Swearing orAMmnng
Sign*- o/ Notary Publict State of Florida
ANG FI A YOIINr
Name of Notary typed, Printed or Stamped
c ANG_iAY Conmisscnt GG 9G9688od W Personally Known
E„res,',pri1122024 ❑ Produced Identification
o�oP ew.a nwaecmxom+ry s.rym
Type of Identification Produced!
Place Notary Seal Stamp Above
Completing this information can deter oIteration of the document or
fraudulent reattachment of this form to an unintended document
Description of Attached Documerrt
TMe or Type of Document
Document Date:
Signer(s) Other Than Named Above:
02019 National Notary Association
Number of Pages: