HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (• , Permit Number: �ry���Vy� �py •
_.. AUG 11 2096
Building Permit Application
Planning Ind Development Services
Building aid Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (7172)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
FR{ PD5EgllllP.R{3 / ttICITLOCf/ TI }N.. .. .. . _._ �� n �
Address: 1102 N 41ST ST, FT PIERCE FL 34950
Legal Description: PLAT 2 SUNLAND GARDENS BLK 34 LOTS 1&2
2405-703-0019-000-3 1&2
Property iax ID#: Lot No.
Site Plan Name: Block No. 34
Project Name: SMITH
Setbacks Front Back: Right Side: Left Side:
ETILEIESCRIPTIO'NyaF WQRK ,
CHANGIE OU bDOOR NO SIZE CHANGE
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C�JNSTRU��TIDN INF{�RMATIO;N " _�
Additional work to be performed un er t is permit-check all appy:
rE:1HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers 1:1Generator E] Roof
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Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1387.45 Utilities:1 —1 Sewer L_1 Septic Building Height:
ONERJLE r `C1TRAR " x
Name ian Name: I
Address: Company: J&G CARPENTRY INC
City: 017State: Address: 1102 N 41ST
Zip CodFax: City: FT PIERCE State:FL
561 855 4054
Phone No.��� 34950-�i,`� •) Zip Code: Fax:
E-Mail: I Phone No. 561 855 4052
Fill in feed simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CGCO22831
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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�SPPLEf�li� 1LCONaTECTi i:itU LAUI/ �i`���RMATitYI� � AT
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ of Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: I Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _ of Applicable
Name: I Name:
Address: I Address:
City: I City:
Zip: I Phone: Zip: Phone:
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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 jobsite
before th'e first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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Os
Signatt r�,��wner a essee/A.,gent I atu e o Contractor License Holder
STATE OF FLORIDA STATE OF FLORI
COUNTY OF �: X41 Or (,1 cj,4- COUNTY OF M I tin P(�C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisZo day of u20 [�by this—y—day of A!)
20 -by
�y��'t�RGu lTSY►'bl^I'i', �I�VVI��:�_I�G�I/( S
(N�of person acknowledging) (Name of person acknowledging)
(Signatureof Notaryb Sta ;of Florida) (Signature otar ublic-St of Florida)
Personally Known OR Produced Identification Personally Known L//"'OR Produced Identification
Type of Identification Produced _L• Type of Identification Produced
�':':•.PBZ% BARBARA J.ZIEGLER
Commission No. �(9&WMMlSSl0N#FF9032l6 Commission No. o<P��?°a�,c @�YOUNG
EXPIRES:October 7,2017 h1Y COMISSfON FF 951069
Bonded ThruBudget Notary Sentcec I EXPIRES:Apn1112020
6onao inn+ ud59 otary ernces
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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