HomeMy WebLinkAboutBuilding Permit Application - WoodAll 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:
PROPOSED IMPROVEMENT LOCATION:
Address: ``I n Q V,,, -- -
Property Tax ID #: �`��-�� ��3� l<<� -��� " ( _ Lot No. _
Site Plan Name: Block No. _
Project Name:--
r DETAILED DESCRIPTION OF WORK:
0(19--
CONSTRUCTION INFORMATION:
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: $ \, ' ` Utilities: —Sewer _ Septic Building Height:
OWNERAESSEE: ` CONTRACTOR:
Name UAJ6 Name: JAMES E REYNOLDS
Address: ��E�- v-J6 Company: CORAD INC
City: two k l-JCAC-tate:'�L Address: 2771 VISTA PKWY STE F11
Zip Code: , �y 1 �� Fax: City: WEST PALM BEACH State: FL
Phonc No. I, 7ip Code: 33411 _ Fax: 561-771-0049
E-Mail: Phone No 561-771-0047
Fill in fee simple Title Holder on next page ( if different E-Mail REBECCA@PERMITGROUPFL.COM
from the Owner listed above) State or County license CGC 054348
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable j
BONDING COMPANY: Not Applicable
Name: i
Name:
j
Address:
Address:
j
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 rues, 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 ► 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. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
A
Signatur of Owner/ Lessee/Contracto a Agent for Owner Signatur of Contractor/license Holder
l
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
The forgoing instru ent was acknowledged before me The forgoing instru ent was acknowledged before me
20"=1 by this � day of 20LL by
this,2 day of
i
JAMES E REYNOLDS JAMES E REYNOLDS
Name of person making statement. Name of person making statement.
ori"
Personally Known ocl @' tf Pdl ri�t�t Personally Known OR Produced Identification
tep
fi i n euenca
Type of Identification
Type of Identi scat o 8 YP
YP My �omrrnsson GG 95884
Produced Expiras 02116/2024 Produced
"s+14 A Notary Public State of Florida
Rebecca E Stephens
MY L �J� �' • Ces 02/1 i958848
Ex
Ex Tres 02/18/2 24
(Signature of Notary Public- State of Florida) (Signature of Notary
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.