HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��® I O 415 Date: 01/02/2020 Permit Number:
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IVeD
-- - Building Permit Applicatio
Planning and Development Services 2 3 2020
Building and Code Regulation Divisionnty, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE:Garage Door Replacement
PROPOSED IMPROVEMENT LOCATION:;
Address: 2404 Tamarind Dr.
Property Tax ID#: 1436-601-0012-000-4 Lot No.11 &21
Site Plan Name: Block No. 1
Project Name: Sampson
{'DETA11UrD DESC RIPTI:ONIOF!. `,',ORK,
Replace 16 x 7 Garage Door Size fop Size
CON'STRUCTIO'N'IiN!FO.RMATI,ON:'
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: Sq. Ft.of First Floor:
Cost of Construction:$ 2,209.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE, CONTRACTOR.
NameJohn Sampson Name:Mitchell O. Pierce
Address:2404 Tamarind Dr. Company:Quality Garage Door Services
City: Fort Pierce State:_ Address:1429 Chaffee Dr. Suite 1
Zip Code: 34949' Fax:N/A City: Titusville State:fL
Phone No.772-579-6275 Zip Code: 32780 Fax: n/a
E-Mail: Phone N0772-232-7019
Fill in fee simple Title Holder on next page(if different E-Mail gUALITYGARAGEDOORSERVICES@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.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
S,UPP EIVI+ENTAL CO'NSTR'UCTiC I LI'ENI'LAWa IN MAT
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 OWA ATTORNEY BEFORE RECORDING YOUR NOTI OMMENCEMENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FL DA STATE OF FLO DA
COUNTY OF t^G-o � COUNTY OF (DnGV,Ard
The for May
instr Eent was acknowledged before me The forgpping instrument was acknowledged before me
this Yay o&Q_ Pnv%^ 20 2j3by this Z%4day of 4X� 20VO by
Y`1 Com-uk"_,li 1 C) 1P�-C"'CA _
Name of person making statement. Name of person making statement
Personally KnownOR Produced Identification Personally Known _OR Produced Identification
Type of Identificati n Type of Identification
Produced Produced
4 �
(Slg ture of Notary P I S e Oh&OOAI C State of Florida ( i ature of Notary Public4Stat
LisaA Stevenson ^ Notary Public State of Flo idCommission No. ( ExCorp�iV2 20 212244 Commission NoGGZ-12xSe0o Stevenson
Expires1��f24l2020 Commission GG 212 4� Expires Oti12412020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19