HomeMy WebLinkAboutPERMIT 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:
�L
Address: ;I)5nl W'�St \04-� 6f'
Property Tax lD M: 2.41�q -'401-0O25_COO-4 Lot No. Q
Site Plan Name: Block No. 1
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Project Name: lhrylbriUlc1 U-ca 1lw iD
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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: $ \ )�A(O I® Utilities: _ Sewer _ Septic Building Height:
AACIMIDTiCY- Name: GAMES D. DAVIS
ZNameUQ
Address: W &LP ri (. Company: J&G CARPENTRY, INC.
cm: y-k DrMQ State ti) Address: 13461 79TH CT. N.
Zip Code: "Aq?),I Fax: City: WEST PALM BEACH State: FL
Phone No. `-)E19L PL-rob(QS Zip Code: 33412 Fax: 561-855-405
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
N value of construction Is $2SOO or more, a RECORDED Notice of Commencement is required.
N value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNE ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:_
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER:
Name:
J__ Not Applicable
BONDING COMPANY:
Name:
I( Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
U W NtKy W N 1 Kcal I UK A"IUVI I : 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 ermit holder to build the subject structure
which is in win ict with any applicable Home Owners Association rules, bylaws or an 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 JOB SITE BEFORE THE FIRST INSPECTION. F YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sture of Own
ier/Lessee/ContraRorr as Agent for Owner
Sign eof Contractor/license Holder
STATE OF FLORIDA -
�� L�c� e
STATE OF FLORIDA
COUNTY OF
COUNTYOF—
The forgoing instru ent wadacknowledged efore me
thi51 day of �((L/[�(�.t��1 .20Zby
Thet9($ging instrument was acknowledg before me
this�jdayof /-�iLl✓. .2Q,Q by
Ri, Cole Ryy--QJWL
s4AS b. DAVIS
Name of person making/statement.
Name of person making statement.
Personally Known V OR Produced Identification
Personally Known x OR Produced Identification
TyIdentification
_
Type of Identification
d
E
Produced
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(Signs re of N ry Publi -State
I ANGELAY0Commission
(Sign re o N ry Pu ¢-StateVXA(RY PUBLIC
No. Z 1l 2. ZATE OF FLORIDgnxrr OG2aT01a
_IURIalida
Commission No. iSealipiresADril12,2a24
"'+ev,r�
pires 122720
2 maamvams•�xwrvs."
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ncv. y q io
FL9 MDA JURAT
FS 117.05(131— Effective January 1, 2020
---------------------
State of Ronda 1
County of PAI M REACH Jl
Svrom to (or affirmed) and subscribed before me by
means of
* Physical Presence,
—OR—
❑ Online. Notarization,
this-deyof 1-1 f_2021 ,by
Day Month Year
JAMES D. DAVIS
Nome ofPemon Swearing orAfllrming
Sloatune of Notary —State of Rondo
ANQFI A YODNG
Nome of Notary Typed, Printed or Stamped
ANGELAYOUNG
Rl Personally Known
....... CommissimtGG 968864
❑ Produced Identification
� Exp oA0112.2024
Type of Identification Produced:
Pace notary Seal Stamp Above
Ur IVIYFL
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to on unintended document.
Description of Attached Document
Title or Type of Document
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
C2019 National Notary Association