HomeMy WebLinkAboutWalsh permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
S-nr. LcxtCL- .
Planning and Development Services
Permit Number:
Building Permit Application
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address:
Property Tax ID#: C3 l-� Kno 0-BBV 0Do r Lot No. ) 7 -3
Site Plan Name:
Project Name:
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit- check all that apply
_Mechanical
Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
_ Gas Piping
Cost of Construction: $ I �56' a !?--
Na
S
Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor:
Block No.
i�
Windows/Doors Pond
_ Roof Pitch
Utilities: —Sewer — Septic
Address: D';Llp JkDIAAJ / A/i' th-y'
City: lltwa- State:
Zip Code: 3 Y S�� Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Building Height:
Ls
Company:�F }Lt /�lij7!' DP 7-,Yr- ,
Address: 93% S'n'yxfo
City:_ Rt-// �� State:�-
Zip Code: Fax: % ii'
Phone No 2? a —� tla� �- VSS l
E-Mail_( eiVy) t) Coc-4"-S wyi Pv fe. W to
State or County License Cll(' / 3 3 l 9-VQ
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.
ig
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 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 len er or an attornev 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 LL �:r,
COUNTY OF
STATE OF FLORIDA n�
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T
COUNTY OF J J
Q
Sworpto (or affirmed) and subscribed before m f ' '"• '
✓ °'
;
Sword to (or affirmed) and subscribed before m of'+
Physical Presence or Online Notariz i
this L day of 2020 by 9
✓ Physical Presence or Online Notariz r' rQOr�
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9, :
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this �,+�day of -7 , , 2020 by
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Name of person making statement.
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Name of person making statement. c�
Personally Known OR Produced Identific
In
i
Personally Known OR Produced Identifi >n
Type of Identification
Type of Identification
Produc d
r
Produced
e
(Signatu of N ary Public- State of Florida)
(Signatuk of Wary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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Doors & More
Treafure Coaa Garage Door SpeciaUst
Name C,
Address I O
Street
Wad.
Phone % �ct^(,l S - � xog . C E-mail
Door Size G k'� Model �vrV-
Color: (Wh�ii Almond Brown L C,
Tear Out
Insulation
Doors & More of the Treasure Coast, Inc.
7 8* S King's Hwy
Ft. Pierce, FL 34945
P: (772) 409-4501
F: (772) 252-4633
www.doorsandmoretc.com
City
Windload
Wood 2 X 6 PT V 1lf
Operator e-,.J q I U o L; Ck"a, s4-4pe_ c) (;
Remotes: 1(-Z:) 3 I: 773F�8 Ft
KeyPad p v
Re hook-up motor: Yes
Trim: & No Color: Vo k v- 0 �d
Additional parts: l�rA
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- $ P'v <v c>
C> Service Call $
Lube Door $
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Permit $`
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