HomeMy WebLinkAboutPermit pg 2All 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 Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Property Tax ID #:
Site Plan Name:
Project Name: _
DEMO/ REPAIR
13507 NW COCO PLUM CT
4436-601-0028-000-8
HARBOUR RIDGE
INTERIOR DEMO/ REPAIR
Lot No. 28
Block No.
FIRE DAMAGE TO FRAMING AND TRUSSES IN GRAGE
TERMITE DAMAGE ON EXTERIOR WALL OF MASTER BED ROOM AND BATH WALL
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ _
2,000.00
Name JOHN B CLOUGH
Address: 1316 LANCEWOOD TER
(Affidavit required)
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
City: PALM CITY State: FL
Zip Code: 34990 Fax:
Phone No. 410-371-8191
E-Mail: jbclough@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: JEFFERY J PAULY
Company: JEFFERY J PAULY CONSTRUCTION INC.
Address:
2420 SW MAPLEWOOD DR
City:
PALM CITY State: FL
Zip Code:
34990 Fax:
Phone No
772-263-8268
E-Mail
jjpcbc.jp@gmail.com
State or County License CBC 047770
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: JOSEPH P MCCARTY ARCHITECT INC Name:
Address: 900 SE OSCEOLA ST Address:
City: STUART State: FL City: State:
Zip: 34994 Phone 772-287-6735 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: X 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 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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney befQre commencing work or recording our Notice of Commencement.
Signa r o r/ L ee r as Agent fo ner
r
STATE OF FLO "" ��
COUNTY OF /(�t� ✓ 1
Sworn to (or affirmfMand subscribed before me of tx/- Physical Presence or Online Notarization
this! day of 20ZL by
Name of person milking statement.
Personally Known OR Produced Id e Wication
Type of identificatio r)od cede
(Signature of Notar =State of Florida )
Commission No. (Seal) Caiene Edlund-Chen
I Notary Public
a� --
o c State of Florida
-eva Commit HH006747
s�N(E 19�� Expires 7/13/2024
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