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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: mom Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line MAW Eli e x� �M�r Ln... Address: 7,203 Rc"i 0 Legal Description: t_t`tICCwoo R"t ' U,)17 1D Property Tax ID#: 130 1 ' 7 Lot No.174 ae Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: f MRIVAIR 1016 a `MD()t; SKI S�/ -7 P>ttC tz'> T�VsTR-t-L- NEW � of rlvl� /11,0U Tom. Additi work to be nertormed un er t isTpermit-c ec all tha apply: F_1HVAC L_I Gas Tank Gas Piping Shutters Windows Doors F )— / Electric Plumbing Sprinklers a F]Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ Utilities: Sewer O Septic Building Height: 71VM MIX' low .:.� ,n Name -1 A tL �L1C I CAL F(Je`p- I-fvu�.(.C� Name: .. . '�tl/<J ... . ... L• Address: 'C- ( IVC ' Company: DOS t�1)0 /�P--G 0/= 171 7'C City: �'�f�' }{l}��I - State:/V J Address: 93�1 S Zip Code: C)I9 3ol- Fax: City: rox l fit, - State: 3 ` Fq- 1;335 Phone No. 7 Zip Code: 3 Y Fax: 77 E-Mail: Phone No. n Fill in fee simple Title Holder on next page( if different E-Mail: 9 {x+fSQ o('e (201 7 from the Owner listed above) State or County license: CK�C� P331 �c� If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. ` zk : / Applicable MORTGAGE COMPANY _ DESIGNER ENGINEER: Not : 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE STATE OF FLORR,j��AA COUNTY OF :?7L COUNTY OF NJ(- a The forgoing instr ent was acknowledged before me The forgoing instrument was acknowledged before me this ay of 20.'V by this 1$'wday of 20 so by O/XILJ Pma-, Z, P,-,— Name of person making statement Name of person making statement Personally Known ✓ OR Produced Identification Personally Known 4.-' OR Produced Identification Type of Identification Type of Identification Produced Produced PRIOR (Signature of otary f*; rr#e ��198661 (Signatureo Notary i" 198661 Commission No. ,► EXPIMIJu 2Q22 Explms July 2 2022 Thm IeeorWd800AW70110 Commission No. d�!?hotra�lra8al�nna800 F78tsi REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 Doors & More of the Treasure Coast, Inc. 837 S King's Highway Ft. Pierce, FL 34945 P: (772)409-4501 Do©rs_&More F: (772) 252-4633 Trtaswe Coast Garage Door speciaim www.doorsandmoretc.com QUOTE Name (nC�k t V, 0 Address �W 6_\-10 �,,rs, �� Tor� 1 Street City Phone Ci 7 &,•—_7)Y— ) 3 E-mail �y Door Size 17Y odel _ Xc�� Windload 50 �c Color: '�kl and Ge— Brow rip— $7 Tear Out $ Insulation $ 2 X 6 PT Jambs $ Operator ���� $ Remotes: 1 2 3 Rail: 7 Ft 8 F ( n n t 0� �/ KeyPad $ Re hook-up to existing motor: Yes No A ,, Trim: Yes � No �� -� C_d`dot 'ems Rc� $ Additional Notes: Z715 G' Permit $ �S Subtotal $ L 0 \o a • o QS Deposit $ JO Balance $ N Accepted by Customer Date _ r nature s