HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ) �j
Date: k. Permit Number:
tKECE
L WWI
ISI AUG 2 0
Building Permit Appli;esi
2019
Planning and Development Services itting Department
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial
PERMIT TYPE: Front Door Replacement
PROPOS-D IMPROVEM'ENT.LOCATION
Address: 3609 South Indian River Drive Ft Pierce 34982
Property Tax ID#: 2426-413-003-000-3Lot No. 4
Site Plan Name: Block No.
Project Name: Susan Grimes
DETAILED DESCRIPTION OF WORK
Remove Old front door and install new Impact door
'CONSTRUCTION INFORMATION`
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 19 Sq. Ft. of First Floor:
Cost of Construction:$ 750.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR F.
NameSusan Grimes Name: Gregory A Tison
Address:3609 South Indian river drive Company:Anglers Contracting Inc
City: Fort Pierce State:_ Address: 706 South 5th Street
Zip Code: 34982 Fax: City: Fort Pierce State:FI
Phone No.(772) 201-9044 Zip Code: 34949 Fax:
E-Mail:grimessusan@aol.com Phone No( 772 ) 801 - 1317
Fill in fee simple Title Holder on next page(if different E-Mail anglerscontracting@gmail.com
from the Owner listed above) State or County License CBC#1261151
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SIJPPLEMEIUT�ALCdiNrSTR:t1CTl(�N L1��1 LAUD/ INFORMA�ION� �s �� LES k�� �' � � ;_�
DESIGNER/ENGINEER: X 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
nature=FLORIDA
Lessee/Contractor as Agent for Owner tgnature of Cont or/License Holder
STATE O STATE OF FLORIDA
COUNTY OF l UC.d COUNTY OF
Theing in wa acknowledge fore me The f g instr e t was ck owledg before me
thisday oum nt 20 ° y this ay of 7 20 by
Name of personing st ement. Name of person—mak' g st ement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
i n of N y Public-St e,q f lorida CATHERINE HAVENS (Si ure ota uIc-State of,Por<ida)
KATHERINE HAVENS
MY COMMISSION#GG165030 MY COMMISSION#GG1650 0
Commission No. _ (S@4IRES:LDEC4,2021 Commission No. `JSe�PIRES:DEC 04,2021
Bonded througtate Insurance Bonded through 1st State Insurai ce
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.