HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: a1dA_�_
RECEIVED
Building Permit ApplicatioAUG 31 2021
Planning and Development Services St. Lu9i9 bounty
Building and Code Regulation Division Permi"Ing
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial �_ Residential X
PERMIT TYPE: o� d
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Address: Dr -
Property Tax ID #: �SU - (}_f )U % -0oo Lot No.
Site Plan Name: Block No.
Additional work to be performed under this permit —check all that apply: ,�
_Mechanical _ Gas Tank _ Gas Piping _ Shutters !/"Windows/ oors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Constructions
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name (id. « LA
Address: CP an Dr. 4-70a
City: 2d1SLl/1 �C'h. State:'
Zip Code: '2) 957-7 Fax:
Phone No. 3-%)E -3%2e
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: JAMES D. DAVIS
Company: J&G CARPENTRY, INC.
Address:13461 79TH CT. N.
City: WEST PALM BEACH State. FL
Zip Code: 33412 Fax: 561-855-4054
Phone No 561-855-4052
E-Mail
State or County License CGCO22831
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.
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MORTGAGE COMPANY: _ Not Applicable
DESIGNER/ENGINEER: x 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 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 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
. .. -M .,., ..I .-ff•rnoucv avcnnc nwrnvnimr. YnnR NOTICE OF COMMENCEMENT:'
n1I n I uun L.cnv16�c�v.c ..............�
- ---- ---
ignatuce 4-0-wrier/ Lessee/Co t a for as Agent for Owner
Sig re o Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORI Ate`
COUNTY OF 1 A
COUNTY OF PALM BEACH
The forgoing instr ent was acknowledged before me
The forgoing instriAment was acknowledged before me
day 2 by
this day of 20W by
this of
JAMES D. DAVIS
Name of person making s tement.
Name of person making statement.
Personally Known f3axo r
mol
Personally Known x OR Produced Identification
c GROSS
Type of Identificatjon J EPHD.
Type of Identification
Produced :�= COAA�11SSION#GG350505
Y-� July 30, 2023
Produced
EXPIRES:
< Bonded 7hru tlotary public Underwriters
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(Signature Q D1q�fy: Pufft State of Florida)
(Signat re of Notary PU V ,j tate of FA��9aA61LING
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Commission No. (Seal)
•
a ' q Cvmrnlssie C.968864
Commission No. II
op,, 2024
9rFpF �t,O Bonded Thru Budget NotaryServices
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19