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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: rJ U�LCUL L 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: ., �U�., • �91/ ��L �� p Property Tax I D#: r�•� �I Q o©©jn — Lot No. 0 4- Site Plan Name: Block No. Project Name: _ DETAILED_DESCRIPTION OF WORK: x LS r t-4)! F New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: Mechanical Gas Tank _Gas Piping _Shutters L` Windows/Doors _Pond _Electric —Plumbing ,Sprinklers _Generator !Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: —Sewer —Septic Building Height: 1 Name `` /VDP-057('o D/ 6,1(.t'�SG i� 1 Name: DCA-A)V W6 Address: -Z 0 S "CkSAI't# - Company: �94c /4XID fWAQC©P" City: eDLE ail Lr State:_E-(, Address: g 3 7 SJZ1iV6S "WI/ Zip Code: Ai._ Fax: City:& PCB,f , State: Phone No. ? .1�.` S)�' �� Zip Code: ���J Fax: �7Y 3Sa �3 E-Mail: Phone No 77 —d' t-LSD/ Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 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. 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 le der or an attorney b fore commencing work or recording our Notice of Com encement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of-Contractor/License Holder STATE OF FLOR!� STATE OF lz� C I f COUNTY OFO�A' ��•� COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization < Physical Presence or Online Notarization this&lb day of W\IQ Wye yl 2020 by this day of WJ F iM b4 ✓" 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known L OR Produced Identification Type of Identification Type of Identification Pr duced Produced y 11 lij l Ll'_L (Signatur -wC rIe s SINe IM (Signature of Notar Pubic-State of Florida Comm Tis6ion#HH 041 si1�" ,,. CHRISTINA B,JEWETT ( Commissi ep}� ;.: eal) p�liber13,20 4 Comm *' f, Seal ':f°j;�°`` Raided Thu Troy fain Msurance 800.3857019 'o`, Expires September 13,2024 REVIEWS FRONT ZONING SUPERVISOR PLAN ANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20 Doors & More of the Treasure Coast, Inc. 8'_Y7 = S King's Hwy qg"p Ft. Pierce, FL 34945 P: (772) 409-4501 Doors & More F: (772) 252-4633 Treawrr Coau urge oeo.SpetNltst www.doorsandmoretc.com QUOTE r Name r�f.J � i to S C' Address Grc) 2 r 6f 3 / Street City Phone — 3 3 7 S E-mail Door Size l4 Model Windload + b� Color: White Almond Brown Tear O $ Ins ion $ Wood 2 X 6 PT $ .•�' ..f Operator $ Remotes: Rail: 7 F KeyPad $ �- Re hook-up motor: No Trim: Yes No Color: Additional parts: Tax $ Service Call $ Lube Door $ Permit lD D o c� �"� 0" Deposit $ j�� TOTAL Accepted by Custome Date Sign ure