HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Data, Permit Number:
•
Application
- Building Permit
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34992
Commercial Residential
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT TYPE:
L
Address:
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
cn�,OUA . doors log 3i7l, ct=!g, ^P4c
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 Poch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 'q-CLO LSO Utilities: _ Sewer _ Septic Building Height:
Name 01MA Qf Name: JAMES D. DAVIS
al q I � F- onf2mcm Rd Company:38G CARPENTRY, INC.
Address:
City: NO(l P 1 (CQ State: Address: 13461 79TH CT. N.
Zip Code: UI5 Fax: City: WEST PALM BEACH State: FL
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Phone No. TJ O r)Y G, a� Zip Code: 33412 Fax: 561-8554054
E-Mail: Phone No 561-8554062
Fill In fee simple TRIe 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 NVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNE
ENGINEER: x
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:_
City:
State:_
Zip:
Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
Not Applicable
BONDING COMPANY:
_Nat Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip:
Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIOV IT: Application is hereby made to obtain a permit to 0o rite wort ano it nanaaon as mmcatea.
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 concurfency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessary 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. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
winnu vn"o t FNnFo no AN ennom" nFFnRF REGnRnING YOUR NOTICE OF COMMENCEMENT.'
�er/
Signature ofo ess� radar as Agent forOwner
Signature of Co ra r/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF rri"TI AJ
COUNTY OF anus --
The fo ding instrum nt was acknowledged before me
The for oing instrument was acknowledged before me
this day of I L- 2021 by
this day of A ar 20 L by
woes D. DAVe
Name of person making statement.
Name of person making statement.
Personally Known _ OLProduced entific ion --I
PersonallyKnown x OR Produced Identification
Type of Identification
pe of Identification
Produced
m ded Hanov
duced
eoc Trait-siaa GG UB1iB9
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Nc u -)
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(Signatu of Notary Pu c, ?'late of Florida) ..
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Commission No. (Seal)
Commission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
evv
PLOWDA JURAT
FS 117AM13)-EffecWe January 1, 2020
Pe 999H1Ri93BBB9F6
State of Fonda
County of PA M a ACH
Swam to )or affirmed) and subscribed before me by
means of
Ml Physical Presence,
—OR—
E] Online. Notarization,
this . 'IK dayof A nc . l 2021 by
Day ' Month year
JAMES D. DAVIS
NNaaam/e of Person Swearing or Affirming
S
lign6furem Putllk— tateofFlorida
ANGEI A YQI NC
Name of Notary typed, Printed or Stamped
10 Personally Known
❑ Produced Identification
- Type of Identification Produced:,
Place Notary Sea/ Stamp Above
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Completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type
Document Date:. Number of Pages:
Signer(s) Other Than Named Above:
ale®
02019 National Notary Association