HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services JUL Nit'
Building and Code Regulation Division PER rin-TING
2300 Virginia Avenue,Fort Pierce FL 34982 �, ,,� unty, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resid"enlay ,o
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 13605 S. Indian River Dr.
Legal Description: RE-S/D of 9/10-37-41
Property Tax ID#: 4509-801-0009-080-0 Lot No.
Site Plan Name: Jordan Block No.
Project Name: Natasha Jordan
Setbacks Front Back: Right Side: x Left Side:
DETAILED`DESCRIPTION OF WORK:
Replace 2 ea. 9 x 7 Garage Doors Size for Size
CONSTRUCTION INFORMATION:.
Additional work to be performed under tispermit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers E Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 2,363.00 Utilities: Sewer Septic Building Height:
OWN`ERAESSEE: CONTRACTOR:
Name ?A%.Ltt lyp R&3 4&(L Name: Mitchell O.Pierce
Address: r,p. Ok id1fi� Company: Quality Garage Door Serivices
City: 89""- F1 -i1aAq4J_--Jwe. State: F Address: 116 S. Park ave.
Zip Code: 3486;7 33Z>06 Fax: City: Titusville State:Fl
Phone No.321-917-4159 Zip Code: 32796 Fax: 321-264-7416
E-Mail: Phone No. 321-264-6399
Fill in fee simple Title Holder on next page(if different E-Mail: Qualitygaragedoorservices@yahoo.com
from the Owner listed above) State or County License: CRC1329903
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: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing,consult with leader or-ao attorney before
commencing work or recording our Notice of Commencement.
s
Signature of Owner/Lessee/Contr for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORI
COUNTY OF COUNTY OF LVA!'
e re E
The for oing instruments acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 fby this Z"1 day of�i�. 6,4 _ 20 by
� v
(Name of person acknowledging) (Name of person acknowledging)
rA
(Signature of NotaTV Public-State of Florida) Q eof Notary Publi -State of Florida)
Personally Known OR Produced en ification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. /5r _ mission No.G�D ea,)--
KAREN S. NIELSE VP
ipµY PUp i, y�f; -
Commission ;f FF FF 115 37 LISA A TINDALL
.- 024256
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my
,l EXPIRES August 24,2020
Revised 07/15/2014 "�" _:------_-=�_ -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS