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HomeMy WebLinkAboutSzlosek 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 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential L' PERMIT APPLICATION FOR: �,-p �q,�1— � A& - -- - PROVEMENT LOCATION: Address: qqVq_A), j41(t�1wh+_1 A-lig(.�►d�l % .l �: li�.{�%� }-� � Property Tax ID #: 1 (pD L 002 3 We Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION CIF WORK' �A16 9URL)C AW&; ZIJ/VA�1 40DCz- g'�) New Electrical Meter Second Electrical Meter CC3 S�TRUCTION INFORMATION: - ---.-� Additional work to be performed under this permit -check all that apply: j _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 mUtilities: _Sewer _ Septic Building Height: Name_ -A l-A-Al SZGU Address: APC. City: SehXI N 6! State: L Zip Code: 3 38 7 /P Fax: Phone No. Y6q E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Di -:"A AI 14 /1w L: Company:_&00'S A*,)�) r%10A,6- Qlt1)W&-r ' A- Address—'�, 3 7 s. City: -_ t / i/L�'LC� State: �- Zip Code: Fax: Phone No 7 �/��- 9 5—D / E-Mail Joann d-J o6DV,SQtd/YtUre State or County License CAC f 3�l Sly 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. DESIGN[ Name:_ Address: City: _ NGINEER: — Not Applicable Zip: Phone State FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: �..��.�ni a.viv t nraa, t Vn Hrriuvi 1: 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 lenkr o� r an attorney before commencing work or recording your Notice of Commencement. Signature of'Owner as Agent for Owner I Signature of Contractor/License Holder STATE OF FLORIDA �//<I STATE OF FLORIDA 4 COUNTY OF Z-61Z �.�ce COUNTY OF �fT Sworn to (or affirmed) and subscribed before me of ✓ Physical Presence or Online Notarization thii/ssa 8 day of 2020 by Name of person making statement Personally Known ✓ Type of Identification Produced re df Notary Commission No. REVIEWS DATE RECEIVED DATE COMPLETED OR Produced Identification Mii METTYPRIDE -Mate-mv"MM Uu 19051 n `oho Expires July T 2022 ' "" Bonded Ttv�T�q �,�n Mturance 800.385T019 Sworn to (or affirmed) and subscribed before me of 'Physical Presence or Online Notarization this 2 Sday of �._r -�1 2020 by Name of person making statement. Personally Known ✓ OR Produced Identification Type of Identification Produced tw�iw+r�r+wnr, xis BET YPRIDe (Signature of otary Publi ily2.2022 Commission No. COUONTER I REVIEW I SUPERVISOR REVIEWI REVIEW I VEGETATION I S REVIEW LE I MANGROVE Treasure Coact Garage Doar SprtiaFist QUOTE Name /__rII14?A -)Zr1 Doors & More of the Treasure Coast, Inc. 837 S King's Highway Ft. Pierce, FL 34945 P: (772) 409-4501 F: (772) 252-4633 www.doorsandmoretc.com Address Street City Phone Y6 1 — Ifgc— 0409 E-mail 8rl3-- q -(&--OSS,S Door Size Model 0 �I Windload "k"-50" &n P j our(, i CRC KG S� Color: White Almond Brown Oak Cherry $ l c S- Tear Out $ Insulation $ 2 X 6 PT Jambs $ Operator � ° A- &1O c4-Q-(E— Y160 $ Remotes: 1 (V 3 ail: 7 Ft 8 Ft ©D KeyPad U_oa� $ Re hook-up to existing motor: Yes �v�! Trim: rer No wl,.l �' $ Q Additional Notes: Permit Subtotal $ 't Te1Q0 Deposit $ D ri > Balance $ Accepted by Customer Date g�,� d Sign e >