HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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I= L- c1 t; u c CA--''' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: U "% AJ *k B*4Z 4..
Property Tax ID #: 3 Y / e - S"V / - 9,/
Lot No. � O
Site Plan Name: /2.� �F,!- ,i1�-/c Block �1
No.
Project Name:
DETAILED DESCRIPTION OF WORK:
/L�///.c cc !�)e c )C� G1"/e-c 4.' l✓.f- tf��eiz /.%c ,l.�r /� ic, e
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical — Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
—Electric I'lPlumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name //.k-'141 S.,g,,,,y�; y z�
Name: JOSEPH FTULLY
Address: �7 w�°1 f /s+�bd. �„�
Company: GENESIS PLUMBING SERVICES INC
EI
City:... 641 -- 17- State:
Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
_
Zip Code: 3 �115-;2 Fax:
City: PORT ST LUCIE State: FL
Phone No. `772 41.S 7 3.2,E
Zip Code: 34952 Fax.
E-Mail:_ . ^jl ��y�� c
Phone No 772-337-3682
Fill in fee simple Title Holder on next Waage ( if different
E-Mail GENESISPLUMBINGOFFICE@GMAIL.COM
from the Owner listed above)
State or County License CFC1429103
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:_
Address:
City: _
Zip:
Phon
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State:
— Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
State:
_Not Applicable
VVVIMM/ WIv I KAG I UK 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 attornev before commencine work or rernrrling vnur Nntirp of C'nmmPnrPmPnt
Signature of Owner/ Lessee/Contractor as Agent for Owner
gnature of Contractor Licens
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY 0FSTLUCIE
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this day of 2020 by
this _/_t day of D e_4j 4 2024 by
BARBARA J LOPEZ
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
P oduced t
y_ f Jj
(Signature of Notary Public- State of Florida)
(Signature of Notary Public. e o ioricl ' )
BARBARAJ.LOPE
Commission No. )
(Seal)
HH099764 2pA�Ny B(p
Commission No. VaIpommission#HH099
*
N r Expires April 24, 202
oQ�� horded Thu a9110 Noun Se
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Rev. 5/ b/ LU