HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
COUNTY
F L O R I D A
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Permit Number:
Building Permit Application
Commercial Residential
PROPOSED IMPROVEMENT LOCATION:
L
Address: (n4�') 5C N`ce ►2�V �r
Property Tax ID #: '59 L7 _ 7C Lot No. J _
Site Plan Name:
Project Name: ` t :-
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Block No. 13,
Z v"k
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: $ 'S �i 5-TCJ Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
Name
>, o. (6�\ `�e Inkd"-K-C-
Address:
6;2-0 31�7 i A'L", 9-iyk r
l->r
City:
State: C-L—
ZipCode:
3�1`�� Fax:
Phone No.
E-Mail:
St"c;. rv-�
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: JAMES E REYNOLDS
Company: CORAD INC
Address: 2771 VISTA PKWY STE F11
City: WEST PALM BEACH
State: FL
Zip Code. 33411 _ Fax: 561-771-0049
Phone No 561-771-0047
E-Mail REBECCA@PERMITGROUPFL.COM
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.
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 conflicts with anY applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 before commencing work or recording our Notice of Commencement.
I
— 61�� C_ - .
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Sig ure of Owner/ lessee/Cont for as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of ✓ Physical Presence or Online Notarization
this 16 day of 201:Z—by
J(LM4_5 1�_ tura t'4s
Name of person m king st tement.
7OR
Personally Known Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
per * Notary Public state a F�anda
ii�
Rebecca E Stephens
My Commission GG 958848
w w Expires 02/16/2024
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Rev 5/20/21