HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BECOMPLETEDFOR APPLICATION TO BE ACCEPTED
Date: I' ��- / Permit Number:
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Building Permit Applical ion NOV 1 2019
Planning and Development Services
Building and Code Regulation Division Permitting �e��f�P7� � 1
2300 Virginia Avenue,Fort Pierce FL 34982 1
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Re ide ally cie County, F .
PERMITTYPE: d//7 lass
PROPOSED IMPROVEMENT L, :C IQ
Address: 3880 N HWY Al 80.4
Property Tax ID#: 1423-805-0096-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILEDDESCRIPTION OF WORK
Install sliding glass door in one opening
CONSTRUCTION INFORMATION - _
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters V Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: jj Sq.Ft.of First Floor:
Cost of Construction:$ "7 (0, Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR
NameSharon Coleman Name:Ray Reinhard
Address:3880 N Hwy Al 804 Company:FIBS, Inc.
City: Ft.Pierce State:_ Address:722 3rd Place
Zip Code:.34949 Fax: City:Vero Beach State:FL
Phone No.404-275-1521 Zip Code: 32968 Fax:
E-Mail:diamondgirl22@comcast.net Phone N0772-567-7461
Fill in fee simple Title Holder on next page(if different E-Mailtammy@hbsglass.com
from the Owner listed above) State or County License SCC131151281
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.
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SU,RPLEIVIENTAL,CONSTRUCTION LIEN'LAW IN`FORIUTATION
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 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 N0311M EMENT."
Si nature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID / /� ' STATE OF FL0AWA d �J
COUNTY OF .�Jldlc�yt /U'l�-Qt" COUNTY OF
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The for oing instrum t was acknowledgedbefore me The f r omg instrumg wa acknowledge"efore me
this ,day of 20_``7 by this�day of / IdLI by
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Name of person making statement. Name of pe son making st ment.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
{Signature of Notary P I c-Stat f lorida nature of Notary u he-St f Florida)
Commission No. #0� Npp��I ublic State of Florid Co missi o. ea
'amm�i C English vt is State of on
My commission Go 906987 F Tammy C English
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REVIEWS FRQN I NS
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Expir oi70/kz2 GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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