HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/13/2018 Permit Number:,$ , d3aA
—:7 RECEIVED
Building Permit Application DEC 7 2��8
Planning and Development Services
Building and Code Regulation Division ST. Lucie county, hermittln�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: \
PROPOSED I!MIPROVEMENT:LO'CATI;ON'.
Address: 6760 N Highway A1A Fort Pierce,34949
Legal Description: 3 34 40N 150 FT OF GOVT LOT 1 LYG E OF A1A WITH RIP RTS AND LIT RTS-LESS N 45.22 FT-(1.30 AC)(OR 1220-666)
Property Tax ID#: 1'403-120-0001-000-6 Lot No.1
Site Plan Name: Block No.
Project Name: Lazotik
Setbacks Front Back: Right Side: Left Side:
DETAILED.DESCRI,PTIClU OF'WORK:
Replace 16 x 7 Garage Door Size for Size
CO,N{STRUCTIO,N I!NFOR,MATIO:N1:
Additional work to be nertormed under t ispermit—chIn appy:
UHVAC Gas Tank Gas Piping _Shutters Windows/Doors
FlElectric Plumbing Sprinklers E Generator E] Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
�
Cost of Construction:$ ;)A_4b O .d O Utilities:n Sewer[]Septic Building Height:
OVI/.NER/L;ESSEE: CONTRACTOR:.
Name Micheal R.Lazorik Name: Mitchell O.Pierce
Address:6760 N A1A Company: Quality Garage Door Services
City: Fort Pierce State: FI Address: 116 S.park Ave
Zip Code: 34949 Fax: City: Titusville State: FI
Phone No.772-489-6524 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 CONSTR;UCTCONi LIEN>,LAW'INIFOR:MAIDWil-
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: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 thepermit 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 gosted on the jobsite
before the first inspecti n. If intend to obtain financing, consult with I . d o attorney before
commencing wor. our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIppA STATE OF FLOgI A'
COUNTY OF 5,'C. COUNTY OF
The forgoing instr4knent was acknowledged before me The forgoing instruUnt was acknowledgebefore me
this-aday of V�-C 20�'l by this-day of %IC 20 by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced . L- L Produced L OL
(Signature of Notary blic-Sta (Signature of ; , Jic-StAkNS _
OEp plNp,MARIE GNEP18; ;+:' ,� MY COMMISSION#GG 022623
Commission No. � � I�Sti1�I GG0220?3 h Commission N S:DONN1 901 20
COMM 2020
er ;a= EXPIRES:pecembet 16. «..,.••• Notary Public Umrmtors
gandedThNN ota ry Pubttc Underwriters
•''�,od„o��
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17