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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INF UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: FOIDr � lication Building Permit App Planning and Development Services Building and Code'Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Department Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re lid r�te�l x tt n� my o F� PERMIT APPLICATION FOR: St. Windo door b., �sm4 n8,s Address: / Legal escription: IJAJ Property Tax ID#: (9")A�—oo Lot No. Site Plan Name: Block No. Project Name: Setbacks 'Front Back: Right Side: Left Side: K •. _ �. c b � m:.•a z <-^vaxq1.'�"«.s •rs r. e.0 sWP �3.N. 'Alij s '•e :4�+c'..' Svas�ti a:: .i> a 'i x Garage Door Replacement-SIZE FOR SIZE-9'x7' Garage Door WHVU �Dc n � moa 'F-Lgig © n r�i q VAIN itionaworto orme under this permit—�c��ec•:. apply: ❑HVAC off Gas Tank Gas PipingShutters .Windo Doors _ Electric Plumbing Sprinklers Generator Roof Roof pitch Total Sq.Ft of Construction: So. Ft.of First Floor: C'j. � c� Cost of Construction:,$ Utilities:0Sewer ElSeptic Building Height: Name Name: Address• Company: A Florida Door Sales Cl State: Addre s• Y' ty. Zip Code: Fax: Ci State:FL Phone No. ' Zip Code: 34974 E-Mail: Phone No. 772435-2886 Fill in fee simple Title Holder on next page(if different E-Mail: jonesyfds@aol.com from the Owner listed above) State or County License: County 25515 If value of construction Is$2500 or more,a RECORDED Notice of Commencement i5 required. can 5UPPLi=NjENTA1 C�Jl�iyUC1701V L e L Appiicahie IEN IAW iNFt?RMAT�QI�t DESINER/ENGINEER: N ;... - Name: MORTGAGE COMPANY: Not Applicable Address: Name: City; Address: Zip' Phone State' City: State• Zip' Phone: FEE:SIMPLE TITLE HOLDER: _Not Applicable BONDING. Name: COMPANY: Not Applicable Address: Name: City. Address: Zip: Phone: City. ZIR' 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 make no representation that is granting a permit will authorize the permit holder to.build the subject structure which is.in conflict Witt 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 financin&consult ith lender or-an attorney before commencing workbr recording our Notice of Commencement. Signature of Own ess Contractor as Agent for Owner Si na ure of Contra r/ se r STATE OF ifl, IDA r � 1 �(� COUTNTY OF�RID { r ,r l f Oct COUNTY OF tr 1 c 1 L lel 1 wt The { ,oing instru . t as acknowled efore me The fgrgoing instru t was acknowledge{ before rite this. I U' day of_ _,ZOby this (�J1 day of 20 i.�by J Name of petro aking statement Name of person p3akirig statement Personally Known OR Produced identification Personally Known OR Produced Identification Type of Identification Type of Identification ProduceProduced d �AA _ (Signature of Notary Public-St Florida k"it MKIER (Signature of Notary Public-S Florida JRjm&mki FA ' `•:fie+ 155rit ",. . a Febr�wGiyB3 Commission No: `�� �` 3.20a Commission No. /yy� dao° eowarwwgar=•+*� t� ��f°FFL�~� irrMThro�u�tMMMr�'� G C-T� REVIEWS FRONT ZONING S � R PLANS REVIEW VEGETATION 5 R TUBE MANGROVE REVIEW COUNTER REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/27 Scanned by CamScanner