HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: I" 10�5 —`Ji s
SCANNED
BY RECEIVED
St. Lucie County
Building Permit Application MAY 07 2019
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
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION -
Permitting Department
St, L County
Residential
Address: 3475 Gordy Road, Fort Pierce, FL 34945 "
Property Tax ID #: 2326-411-0002-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION'OF WORK:
�rgyr vim_— c-tric- I — d--ywA.If j%Ai -,T—
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric —Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
—Windows/Doors
_ Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David & Catherine Coulter
Name: John Ingoglia
Address: 3475 Gordy Road
Company: Jarvis Property Restoration
City: Ft. Pierce State: _
Zip Code: 34945 Fax:
Phone No.
Address:9055 Americana Rd, Ste 26
City: Vero Beach State: FL
Zip Code: 32966 Fax: 586-954-4707
Phone No 772-778-1935
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail dfrederick@jarvisconstruction.com
State or County License CGC1519422
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.
SUPP'LEMENTALCONSTRUCTION UEN LA1%V`INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 INSPECTIPIN. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDI YoUlr NOTICE ON COMMENCEMEN .'
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signa ntractor/ i e e er
STATE OF FLOWA L��� `
STATE O FLORI A
COUNTY OF
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The forgoing instrument as acknowledg5d,before me
The forgg' g instrument was acknowledged before me
this day of key 20_ by
this � day of 20_�7 by
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Name of person making statement.
Name of person makift statem
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Ide tifiu�ontD (x000Uo bat
Type of Identification
Produced
Produced
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FRONT ZONING
SUPERVISOR
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MANGROVE
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DATE
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DATE
COMPLETED
Rev.2/7/19