HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
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 Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 3720 Doral Street
Legal Description: SAVANNA CLUB PLAT PHASE THREE BLK 43 LOT 34 (OR 1072-2067)
Property Tax ID #: 3425-705-0170-000-0
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Re -pipe whole house
Lot No. 34
Block No. 43
CONSTRUCTION INFORMATION:
Additional work to be performed under t ispermit — check a appy:
HVAC LJ Gas Tank L]Gas Piping_ Shutters Windows/Doors
Electric Z Plumbing Sprinklers ❑ Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1,000.00
Sq. Ft. of First Floor: _
Utilities:5ewer 11Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Stanley P Windoloski
Name: Joseph Tully
Address: 3720 Doral Street
Company: Genesis Plumbing Services, Inc.
City: Port St Lucie State: FL
Zip Code: 34952 Fax:
Phone No.
Address: 1902 SE Bolton Ave
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772-335-2680
Phone No. 772-337-3682
E -Mail:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
E -Mail: genesisplumbingoffice@gmail.com
State or County License: CFC1429103
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone. Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: Not Applicable
name:
Address:
Address:
REVIEW
City:
City:
Zip: Phone:
Zip: Phone:
COMPLETE
I certify that no work or installation has commenced prior to the issuance of a permit.
5t. Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may rest
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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
ure of Own
STATE OF FLOH�JIDA
COUNTY OF c�
as Agent for Owner
The f r oing instrument was cknowledge� before me
this day of �,by
(Name of person acknowledging )
(Signature of Notary Public- ate of Florida j
Personally Known OR Produced identification
Type of Identification Produce
MARkAH MILLS
ission # FF 023763
Commission No, �a= {xp�iesJune 3,2017
°� °;,,. B¢�ded ihro 1Ni Fain laaurarce BPP39a1U19
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
COUNTER
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
Contractor,
STATE OF FIL DA .
COUNTY OF
The forgoing instrument was acknowledged(( before me
this day of 1e�e- 20 [6 by
(Name of person a knowledging
Iat re of Notary Public- ate of Florida }
Personally Known OR Produced Identification
Type of Identification Produced
WMARIAH ii S
�5�ssion 0 FF 023?63
Commission No. Exn es June's 2017
��dTCtiTrrFair 's aC -'n7w
PLANS VEGETATION
REVIEW REVIEW
SEA TURTLE I MANGROVE
REVIEW REVIEW