HomeMy WebLinkAboutOberle_Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
hJR:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Property Tax ID #:
Site Plan Name:
Project Name: _
�a
QWANWAR
0 '_-� V
Lot No.
Block No.
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ f _-5'-1/'0 �P
Name Nil"//1N
Generator
"Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer —Septic Building Height:
Address: oZ O&hf- Cpgr bt.
City: r± IC C State:
Zip Code: :Yuq ax:
Phone No. 113
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: ,DG!t;
Company: g�19WS &" 796" 77e,
Address: $37 S, KIAAC, tly*
City: ET -1 P%WW" State: P'
Zip Code: 3 R Fax:
Phone No 2 �' 65
E -Mail dean,r,
State or County License , ti;C 1 .3 31fY
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
s.
DESIGNER/ENGINEER: Not Applicable
Name:
gotr
MORTGAGE COMPANY: _ Not Applicable
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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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 recordiQg your Notice of Commencement.
Signature of Owner essee/Contractor a Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA z
COUNTY OF (; �
COUNTY OF �sL 44�
SWOr to (or affirmed) and subscribed before me of
V. Physical Pre ence or Online Notarization
this day of t, 2020 by
Sworn to (or affirmed) and subscribed before me of
✓Physical Pre nce or Online Notarization
this 6Nay of 2020 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
Produced
(Signature of N tary Public- State of Florida)
ComIBETTYPRID�E 1 (Se )
Jul 2 20
R TTY PRIDE
0
(Signature of otary Public S'at �`{ceWaolon#GG198661
'•.,",`, Expires July 2, 2022
Commission No.s00�86
RE
Tlru Troy Fele Ini
RUM- - .-ZONTNG
&OM
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
aiQ=11
Doors &More
Treasure Coast Write coot Spet141s!
�1 tQUOTE
Name Y V� •'� ��`� h�
Address �,4 LC 6 (a k—\ 'A' V— W Uf
Street
Doors & More of the Treasure Coast, Inc.
93 7 aWt S King's Hwy
Ft. Pierce, FL 34945
P: (772) 409-4501
F: (772) 252-4633
www.doorsandmoretc.com
City
Phone �] ��'� "i � g,- g 1 S 3
E-mail
Door Size C� Model
Windload
—"i R�F
Color: it;;)D Almond Brown
� < $
7S
1,-
Tear Out
L71
d
G$
Insulation $
Wood 2 X 6 j PT (ice $
Operator {— `'� MQ�`!'�''L X& b
Remotes: 1C 3 ail: 7 F Ft
------------
KeyPad $
Re hook-up motor: Yes
Trim: es No Color:
Additional parts:
Tax $
Service Call $
Lube Door $
Permit $
\ �49C $
Accepted by Customer /16t/ �� 1 QaW
Signature
114. OA, �) @ y &�vl, ("