HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f�� rn
Date: S ' C • 1 Permit Number: f '5' v 4-41
COUNTY
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Building.Permit Application ,yqr 09
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Planning and Development Services p�'nn1 ?018
Building and Code Regulation Division Bt,
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peps
2300 Virginia Avenue, Fort Pierce FL 34982 �Le C9�sy ent '
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XXX
PERMIT APPLICATION FOR: other rcle boo r-
PROPOSED IMPROVEMENT LOCATION:
Address: zcc /14c-,r;no, lir , 1-4 Ni prc{,, 349(Ic,
Legal Description: CORAL COVE BEACH-SECTION ONE-BLK 5 LOT 25(OR 4098-2848)
Property Tax ID#: 1425-701-0138-000-6 Lot No.25
Site Plan Name: Block No. 5
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Furnish & install 9x7 Haas 2560 Garage Door
CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit—check all apply:
111 HVAC Gas Tank ❑Gas Piping _Shutters ElWindows/Doors
ElElectric ❑Plumbing El Sprinklers Generator El Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor: I;
Cost of Construction:$ f ,366 Utilities: Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Mi
Name c Mc/Lt;,,,, Name: TerrcwnCL Ce U.,,,1.►,
Address: ZSS /14wr;,,,, Or Company: Customer's Choice Garage Doors&Openers, Inc.
City: Fcr j P -e r-C,1. State:FL Address: Z.70 ri Gttsz cL,‘Gee. ed
Zip Code: 34949 Fax: City: 1-1. p;+ar-ac. State:FL
Phone No.772-216-2303 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:
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:
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 or an attorney before
commencing work or recording your Notice of Commencement.
Sign ure of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA L
COUNTY OF a:vrf •AXI : COUNTY OF ')d y e;4_
The
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of Mai ,20 ) by this CI, day of Mal ,20A_ by
IC V0 1fie: n �e—JJ14-
Name of person making statement Name of pers making statement
Personally Known .J OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Type of Identification
Produced Produced
David Tim one
(Signature of Notary Public-State,- ) P Signature of Notary Public-State oj;,Flq(ida)
_ _ ,=Commission#FF164909 c :'tRYP'O• David Tim one
Commission No. r ='-' fres:OCT 01,2018 Commission No.�T 'f'o�� ~•'• 'oD#FF164909
.,•BONDED THRU M�G•= :OCT O1,2018
''gy m 1Sf FLORIDA NOTARI�.LLC '• ••••7, BONDED THRU
',,�F,ss' 1ST FLORIDA NOTAR4 LLC
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED •
DATE
COMPLETED
Rev.8/2/17