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HomeMy WebLinkAboutCrowe permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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: P:R9I,04C? IMPROVEMENT LOCATION: - Address: U Property Tax ID #: 7 j��©®p Lot No. Site Plan Name: Block No. Project Name: [�DETAILE6 DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter F1(NSTRUCTfON fNFORMATION: Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors Pond _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ I� Utilities: —Sewer _ Septic Building Height: OWNERf LESSEE.77 CONTRACT: NO Name: �A% %� L. Name l� LL - Address: � S' Company: �l% 77.1,c— Address:_ $ City: State: %' Zip Code: Is $1�1` Fax: City: lr�i ec State: �- Phone No, i7L !?7 - 0 Zip Code: 3�f4�t� Fax: 11119 E-Mail: Phone No -)7> — V —11,S D/ Fill in fee simple Title Holder on next page ( if different E-Mail tiyan') Qdaaurd 14oJp 7 e ('©rn from the Owner listed above) State or County License C/-C 1331 sr_YO 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. W M = '..: r. it DESIGNER/ENGINEER: Not Applicable l _ 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 lender or an attorne before commencing work or recording our Notice of Commencement. 16 �JAA'_ Signature o Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDASTATE COUNTY OF �7 OF FLORIDA ' COUNTY OF Sworr) to (or affirmed) and subscribed before me of ✓Physical Sworr�.to (or affirmed) and subscribed before me of Pre nce or Online Notarizati this day of ✓Physical Pres nce or Online Notar' 2020 by ^off+''� _� this day of �ur�. s�� 2020 b ;;?......+i; , M At" Name of person making statement. ✓ + m Name of person making statement. Ln V. Personally Known OR Produced Identifica Type Identification q $ a. Personally Known '� OR Produced Iden is of Produced �~ N # v Type of Identification -+�' o • o iv T Produced N m c� If IC3, (Signs re of r4otary Public- State of Florida) (Si�offublic- State of Florida) Commission No. (Seal) v Commission No. (S If REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 516120 rieasure Coast Garb" 0e06 Name ��a,r � I Address (A < tk <� Street QUOTE Doors & More of the Treasure Coast, Inc. '? `7 MA S King's Hwy Ft. Pierce, FL 34945 P: (772) 409-4501 F: (772) 252-4633 www.doorsandmoretc.com Phone __I ��__ S7 Sy E-mail Door Size C( )c % ModeltU('� Color: it Almond Brown Tear Out Insulation Wood 2 X 6 PT %� G Operator r[_, NV S s� O % d Remotes: 1 (f)3 Rai� Ft KeyPad Re hook-up motor: Yes% Trim: e� No Color: Additional parts: L�l -kqc<, -6 City Windload + SD �v $ $ I 0 ko Ra $ Tax $ Service Call $ Lube Door $ o.OrC 0 Permit $"� $ `TOTAL $ d� Accepted by Custom ? Date Signature