HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9-22-2017 Permit Number:
km RECEIVED SEP 22 2017
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
PERMIT APPLICATION FOR: Window/door i-
PROPOSED IMPROVEMENT LOCATION:
Address: 929 Jackson Way Ft. Pierce
Legal Description: Coastal Coves-Unit 1-Lot 30(or 1243-723)
Property Tax ID#: 1423-802-0032-000-7 Lot No.30
Site Plan Name: 929 Jackson Way Block No.
Project Name: Northcott
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 16 x 7 Garage Door Size for Size Ctwwd�e
CONSTRUCTION INFORMATION:
Additional wor to e e orme under tispermit—check all appy:
HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2,279 Utilities:0Sewer O Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Royce Northcott Name: Mitchell O.Pierce
Address:9590 Trenton Way Company: Quality Garage Door Services
City: Stockton State:Ca.. Address: 116 S.Park Ave
Zip Code: 95212 Fax: City: Titusville State:Fl.
Phone No.772-475-1352 Zip Code: 32796 Fax: 321-264-6399
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 LEEN LAW INFORMATION:-
DESIGN ER/ENGI NEER:
NFORMATION:-DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Royce Northcott Name:Mitchell O.Pierce
Add cess:929 Jackson Way Ft.Pierce Address: 9590 Trenton Way
City: Stockton State: City: Titusville State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:116S.Park Ave 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 Record a Notice of Commencement may result in your paying twice for
improvements to your propertytice of Commencement must be recorded and posted on the jobsite
before the first inspect' I i end to obtain financing, consult wit n or an attorney before
commencingwork o ur Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA—
COUNTY n
COUNTY OF SV 1roc,�a COUNTY OF hr�cy-44
The forgoing instrument was acknowledged before me Theforgoing instrument was acknowledged before me
this�day of 4-�t 20\1 by this a4'Jday of- fn 64r 20_n by
1h�ac
Name of person making statement Name ofr on making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced 'fA- L- Produced
(Signature of Notary Pu GivENs nature of Notary P - ;e of Flo t a
DEANNANI p�`p,3 'e MY COMMISSION#GG024256
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Commission No. . ••''•�`� � coMpIISS��6k1s,2e2o Commission Not aEXP.9% Ngust 24,20200 fit•
PIRES:0 letw=tern�:
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17