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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -(- is" Remo, Permit Number: 1 e r - MAR 2 9...2c078 R COUNTY D r t_ o FL t o n - Pennittk,b ' MAR 4�A � a Buildin pplication 9 ,., Rtropm Planning and Development Services St" 'a9 De Building and Code Regulation Division CuOe r,pBrtrnen 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: k©ln-d opbex,-clit;k ar w,athe=ertd-oHine (3,4.1c D® d* PROPOSED IMPROVEMENT LOCATION t=. Address:7006 Lakeland Blvd Legal Description: LAKEWOOD PARK-UNIT 9-BLK 101 LOT 9(MAP 13/01N)(OR 4036-2529) Property Tax ID#: 1301-611-0009-000-6 Lot No.9 Site Plan Name: Block No. 101 •Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION VOF WORK Furnish and install 16' x 7' Garage Door CONSTRUCTION INFORMATION r „n ,. ; Additional work to be ertormed under this permit—check all apply: ElHVAC Gas Tank Gas Piping Shutters QWindows Doors ElElectric 0 Plumbing Sprinklers O Generator O Roof Roof pitch Total Sq. Ft of Constructio}�nS Ft.of First Floor: Cost of Construction:$ 1� ' L 106 -coG I Utilities:sewer Septic Building Height: OWNER/LESSEE:• :CONTRACTOR: Name / /" J V 25/Or Z VC, Name: Terrance DeVault Jr Address:7006 Lakeland Blvd Company: Customer's Choice Garage Doors City: Ft Pierce State:FLAddress: 2807 Okeechobee Blvd Zip Code: 34987 Fax: City: Ft Pierce State:FL Phone No.(772)528-0881 Zip Code: 34947 Fax: E-Mail: Phone No. 772-675-1066 Fill in fee simple Title Holder on next page(if different E-Mail: drjett@live.com from the Owner listed above) State or County License: 29223 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:R&D Management Name:Terrance DeVault Jr Address:7006 Lakeland Blvd Address: 7006 Lakeland Blvd City: Ft Pierce State: City: Ft Pierce State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address:2607 Okeechobee Blvd 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 f will,in ail 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. Signa a of Owner/Lessee/Contractor as Agent for Owner Signa e oqf actcense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF :So:\e1-i- L G6& COUNTY OF 'w.\an+ b6e- The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 14_day of I'llcxrrJ t ,20_a_ by this in day of V' vJ' ,2.0_a_ by '� an 'D4'a 4- erre fl T v 14` Name of person making statement Name of perspn making statement Personally Known ,/ OR Produced Identification Personally Known e< OR Produced Identification Type of Identification Type of Identification Produced Produced • ,.....------ .__ ____—,3------- — ----- ...?:; - l:;$ �� zivid Timpone (Signature of Notary Public-State yP�.sjda bavid Tim ofle„ (Signature of Notary Public-Sta ff I p mission#FF164901 �,' ion#FF164909 Commission No. .�''`4 s:OCT 01 20y Commission No.r Pik LG9 ko•..'' ,ares:OCT 01,2018 P +ICVAI mum 7d BONDED THRU ":t ;;,; .i "enus"'�,` 1SrFLORIDANOTAR1i,L11JC 14 ry:•'� 1ST FLORID NOTA11014��`` REVIEWS FRONT ZONING -SUPERVISOR.. PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW -,: REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED _ DATE COMPLETED Rev.8/2/17