HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ! , I(�
Date: Permit Number: l� O�,p`f 7
Building Permit Application i.
Planning and Development Services !
Building and Code Regulation Division li !
2300 Virginia Avenue,FortPierce FL 34982 '!
Phone: (772)462-1553 Fax: (772)462-1578 Commercial I' Residential x
PERMIT APPLICATION FOR: Window/door Ell
PRO`POS'ED IMPROVEMENT LOCATION
Address: 6049 Travelers Way Fort Pierce,34982
Legal Description: Palm Groves S/D BLK L Lot 27(0.14)(or 3179-2433) I
Property Tax ID#: 3410-503-0365-000-8 i Lot No.27
Site Plan Name: I Block No.
j
Project Name: Ricci
Setbacks Front Back: Right Side: Left Sicle:;I---
F
DETAILED DESCRIPTION OF WORK:
Replace 16x 7 Garage Door Size for Size
! I
CONSTRUCTION,INFORMATION:
Additional work to be nertormed under this permit—check YRM appy: I
HVAC Gas Tank Gas Piping _Shutters I Windows/Doors
Electric 0 Plumbing Sprinklers a Generator E] Roof Roof pitch
i,
Total Sq. Ft of Construction: S . Ft.of First Floor:,i
Cost of Construction:$ Utilities: _ 1:1 Sep
2,349.00 Sewer tic Building Height:
LI I
OWNER/LESSEE:.
CONTRACTOR:l
NameAnthony Ricci Name: Mitchell O:Pierce
Address:6049 Travelers Way Company: Quality Garage Door Services
Fort Pierce 116 S.Park Ave.
City: State:_ Address:
Zip Code: 34982 Fax: City: Titusvilleli State:FI
Phone No.772-873-4169Zip Code: 32796 Fax: 321-264-7416
E-Mail: Phone No. 321-2646399
Fill in fee simple Title Holder on next page(if different E-Mail: qualitygaragedoorservicesdyahoo.com
from the Owner listed above) State or County License: CRC1329903
i
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I
I t
I
i
;I I
i
it J
I�
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: , _Not Applicable
N a m e:Anthony Ricci
Name:Mitchell O.Pierce
Address:6049 Travelers Way Fort Pierce,34982 Address: 6049 Travelers Way
City: Fort Pierce State: City: Titusville ! State:
Zip: Phone Zip: Phone:
I i
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:116 S.Park Ave. Address:
City: City: i
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender ora orney before
commencing work or recording our Notice of Commencement.
410*1'
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contrail r/License Holder
i
STATE OF FLORIDA STATE OF FLQRJDA
COUNTY OF COUNTY OFre Yar�
The forgoing instrument was acknowledged before me The forg ing instrum nt was'acknow;ledged before me
this day of 20_ by this.�_V-day of tJoy m64/ 1,20-1")by
i
ofQI�r"J
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produi ed Identification
Type of Identification Type of Identification'
Produced Produced
i
w
(Signature of Notary Public-State of Florida)
_A(Sign of No%_'itate iMY COMMISSION#GG024256
Commission No. (Seal) Commission No. FIRES 499"24,2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
' I
I
it
I