HomeMy WebLinkAboutBuilding Permit ApplicationII
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All APPLICABLE INFO MUST BE COIF; TED FOR APPLICATION TO BE ACCEPTED -
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Date: Permit Number:
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Building Permit Application JUL 3 1011
Planning and Development Services permittin
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+e county
St. Lucie
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:
s, _.. _
Address: TBA 91/ -Za L e_4 (4 inV
Property Tax ID #: 2428-604-0050-000-9 Lot No. 15
Site Plan Name: Caneus Block No. 3
Project Name: Caneus House
DETAILED DESCRI'PTION.;OF WORK , . F..
Bedroom, 2 Bathroom, 2 Car garage and CBS house.
New Electrical Meter X Second Electrical Meter (Affidavit required)
CONSTRUCTION .I`NFORIVIATIQN..
Additional work to be performed under this permit -check all that apply:
X Mechanical _ Gas Tank —Gas Piping —Shutters X Windows/Doors _Pond
X Electric X Plumbing _ Sprinklers _ Generator X Roof 5:12 Pitch
Total Sq. Ft of Construction: 2,184 Sq. Ft. of First Floor: 2,184
Cost of Construction: $ 174,720 Utilities: _ Sewer x Septic Building Height: 9'4"
:OWNER/LESSEE
CONTRACTOR:
Name I S
Name: John L. George
Address:.S r0 P3 g4eW)l i ij v 10
Company: George & Associates Contractor, Inc
City: - - State: —,-
Address: 686 Old Dixie Hwv
City: Vero Beach State: FL
Zip Code: -__�LE95ZG7 Fax:
Phone No. 2 - tt D
Zip Code: 32945 Fax:
E-Mail: O O-
Phone No E-
Fill in fee simple Title Holder on next page ( if different
Mail;georgeconstruction3@gmail.com
from the Owner listed above)
State or County License CGC1513360
it value or construction is zSuu or more, a ntcuKutu Notice of commencement is required.
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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
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Fof
d b o ner/Agent and applicant:
(Siractor) % l
a, County of sZV Lee_�
Affirmed to and subscribed before me this 0—
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20, by
p-V-
erso Ily known to me or who has produced
as id tification.
Notary Signa
State of Florlda
k GG 109260
Notary (print
(Signature of Owner or Agent (including contractor))
State of Florida, County of
Affirmed to and subscribed before me this
20 , by
personally known to me or who has produced
as identification.
Notary Signature:
otary (print name)
\_ Construction documents must accompany this application. The Florida energy code submitted becomes an integral part of this
plan and must pass final inspection. "Notice: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public record of this county, and there may be additional permits required
from other governmental entities such as waste management district, state agencies, or federal agencies. "SIGNATURE OF THE
APPLICANT MUST BE NOTARIZED. If owner builder, applicant must sign in person. BUILDING PERMIT includes:
Building, Electrical, Plumbing, Mechanical, and Sewer only. All other trades require separate applications.
Asbestos compliance: It is the owner's or operator's responsibility to comply with section 469.003, Florida Statutes, and
to notify the Department of Environmental Protection of his or her intentions to remove asbestos, when applicable, in
accordance with state and federal law.
FEE SIMPLE TITLEHOLDER, BONDING COMPANY AND MORTGAGE LENDER INFORMATION IS REQUIRED WHEN
THE AGGREGATE VALUE (TOTAL COST OF ALL IMPROVEMENTS AND NOT JUST WORK AUTHORIZED BY THE
INDMDUAL PERMIT) IS $2500 OR MORE (EXCEPT HVAC REPAIR/REPLACEMENT< $7500). PLEASE ADDRESS ALL
ITEMS.
Fee Simple Utleholder's
Name (if other than owner):
Address:
City:
❑ Same as Owner
State: Zip:
Mortgage Lender's ❑ Not Applicable
Name:
Address:
Bonding Company ❑ Not Applicable
Name: _
Address:
City:
State: Zip:
City: State: Zip:
OFFICE USE ONLY
Is the property located in a Special Flood Hazard Area (floodplain) per the current Flood Insurance Rate Map (FIRM)
Flood Zone:
Permit Fee $
State Surcharge $
Subcontractor $
Reviewed by:
Total Amount Due at Issuance
Remarks
Other
Other
❑ Yes ❑ No
Determination:
$ Plan Review Fee
Flood Review Fee $
Routing Fee $
Other $
Active Code Violation ❑ Yes ❑ No
Case #
Case Type
Reviewed by
Date Final Check
Date
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