HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �•�Q' �� Permit Number:
RECEIVED
Building Permit Application APR 3 0 1011
Planning and Development Services F�rmitt.�g =aartmert
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial _u, Residential X
PERMIT TYPE:
Address: "1(10 W �1L.t ny) 6�Property Tax ID#: ic�1�1 a- blo -0m c� ' -� Lot No.
Site Plan Name: Block No.
Project Name:
an i Or o -
Additional work to be performed under this permit—check all that apply:
,Mechanical ,Gas Tank _Gas Piping _Shutters Vwindows/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 Name:DAMES b.DAVIS
Address:l_bq(�_) CXO AAQ) 6 �J1 Company:J&G CARPENTRY, INC.
city:�����T State:IC Address:13461 79TH CT.N.
Zip Code:( Fax: City: WEST PALM BEACH State:FL
Phone No. ::7 4 0 3� 1d Zip Code: 33412 Fax: 561-855-4054
E-Mail: Phone No 561-8554052
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License GCO2283
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 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 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 Assoclztien ru!es,bylaws or and covenants that:nay 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
"WARN■IIG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYWG
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 OBTAW FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.-
i
i
Ig ure of Own r/Lessee/Contracto as Agent for Owner Signature of Con ct /License Holder
STAT OF FLOR DA STATE OF FLORIDA
COUNTY OF COUNTY OF PALM BEACH
The f r oing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20a I by this at day of 20j2A by
Gt-. ,! WLL(�(Vp p JAMES D.DAVIS
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification_l��S Personally Known x OR Produced Identification
Type of IdIeSnti�ftation 1 Type of Identification
Produced-1 i vat, Produced
(Signatur of Notary Public-State of Florida)
t►rYP� MARY LEE MATfIS (Signat a of Not dry Public- tate of Florida)
r°,`'•••.�k+ aY u M°IGEIAYOUNG
Commission No.1440 q hn6HH0894
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(Sea Commission No, ,• 3 Cct,-,�( �GG9c.8864
a„ c` Expires March 6,2025
E Aires April 12,2024
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
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DATE
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