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HomeMy WebLinkAboutGARAGE DOORS All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � Z Permit Number: 1A4)"'\ 3�y =: s ID _ Building Permit ApplicatioERECEVE SSP 14 2018 Planning and Development Services Building and Code Regulation Division ucie County, PermittinO 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax:.(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: � o' T PR®P©SED INRR®VEMfENT LOCATIUN: Address: 2 6 P4.4,, tV, Legal Description: �n. ��C�/ti lug O �o� /6 k 7 4J i t,Ix / &&!!S e.. Property Tax ID#: 60A.O ' d d- I Lot No. Site Plan Name: Block No. Project Name: Setbacks Front y� Back: Right Side: Left Side: DETAILED90,5800&1, AN 1Q4=R' AddCtJNSTRUCTIC�N I�NFORiMATlQN: itiona wor to a pe orme under tis -checkpermit a that apply: Mechanical _Gas Tank Gas Piping _Shutters Windows/Doors Electric _Plumbing _Sprinklers _Generator ' -Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: OW�NFRjLE-��SEE: CON RACTQR: Name Nem. ISurw5 Name: �W:5sru Address: 520 - Pio -4OL)'2 5 'r Company: C'-"z A3vr-5 City: State: re Address: Via;V-`ycu A) !4e,0 -1' Zip Code: Fax: City: '-�05L- State: /rL Phone No. Zip Code: Nf S-5 Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail rs(0 r from the Owner listed above) State or County License 2-S3r-fS If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Sl1 PI EMENl" CCNTI®NLL ; KWIRCE iN`EORMA 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'g'ranting 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-r'esidential 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.Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder -STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S>-. COUNTY OF Sir . 1.yc I"k The forgoing instrument was acknowledgedbefore me The forgoing instrufnent was acknowledged,before me this day of ��Q�t 20 by this day of p'n 20 by � :5 SA C_ 9\_­)a1Z (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pu lic-State of Florida) (Signature of Nota Public-State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Idii Type of Identi icationy Type of Identification RiEGNt-Ns mA.MA 023 Produced L-. � '~ Produced D� GGO� Gh+Flh'� ti ........ MY MY C116.2020 < NAMpg1E 0:20'3 '_� P1RES:Decembe envrter, Commission No. GpMi��gr16't',,0 r,} Commission No. � jhNotary� `�a ��sN s�yo�� O REVIEWS NING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE C INTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.