HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
06/22/18
Date: Permit Number:
•
Building Permit Application
Planning and Development Services �, JUN/41 .7.t
Building and Code Regulation Division /41
FL 34982
Phone2300 : (inia 772)462u1553 Faxe,Fort : (772)462-1578 Commercial Residential x / M0ep���
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PERMIT APPLICATION FOR: Window/door -i
-PROPOSEDIM'PROVEMENT LOCATION:
Address: 5403 Silver Oak Dr.
Legal Description: Indian River Estates Unit 05 Blk 22 Lots 26,27
Property Tax ID#: 3402-606-0063-000-2 Lot No.26,27
Site Plan Name: Block No. 22
Project Name: Spikes
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 16 x 7 Garage Door Size for Size
CONSTRUCTION INFORMATION:
Additionalworkto e e orme under tispermit—checka appy:
F]HVAC Gas Tank Gas Piping _Shutters ✓❑Windows/Doors
Electric 0 Plumbing ❑Sprinklers ElGenerator F] Roof Roof pitch
Total Sq. Ft of Construction: Ft.of First Floor:
Cost of Construction:$ 1,550.00 Utilities,: Sewer Septic Building Height:
OW,N`ER/LESSEE: CONTRACTOR:
Name Ricky E.Spikes Name: Mitchell O. Pierce e
Address:5403 Silver Oak Dr. Company: Quality Garage Door Services
City: Fort Pierce State:Fl Address: 116 S. Park Ave
Zip Code: 34982 Fax: City: Titusville State:FI
Phone No.772-940-6092 Zip Code: 32796 Fax: 321-264-7416
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 LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Ricky E Spikes N a m e:Mitcholl O.Pierce
Address:5403 Silver Oak Dr. Address: 5403 Silver Oak Dr.
City: Fort Pierce State: City: Titusville State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Add cess:116 S.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 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 le or attorney before
commencing workpr r in ur otice 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 FL A nn
COUNTY OF —. J�LC�I,Q. COUNTY OFyAnco
The"oing instrurpent was acknowledged before me The forgging instrument was acknowledged before me
this !iday of Y1L 20�S by this29LWday of::zry-_ 201% by
Name of person kan nim nim g statement / Name of person making statement
Personally Known OR Produced Identification V Personally Known X OR Produced Identification
Type of Identification ` Type of Identification
Produced 1 `Q Produced
(Signature of Notary P lice, a of Flori a ignature of Nota PIUTito plit eo on AWN MILONEa1`ts�e �onMY COMMI ION#GG 049998My Commission GG 212244
Commission No. <s EF� I March 22,2021 Commission No. �� Expires08124( I�
o ;g:'• Bonded Thru Notary Public underwriters G�2 —`�q
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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