HomeMy WebLinkAboutBUILDING PERMIT APPLICATION_- '\
ALL AF
Date:
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Nmxj�q
7 / A� PermitNumber:
SCANNED
BY
at. Lucie coun�j
Building Permit Application
Plannin and Development Services
Bui/dind, land Code Regulation Division
2300 W gmia Avenue, Fort Pierce FL 34982
Phone I(772) 462-1553 Fax: (772) 462-1578 Commercial
0
RecEn/Eo
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Pe 1tEletuo^wcCept
Residential J
PERM I APPLICATION FOR: Window/door
El
PROPI SED IMPROVEMENT LOCATION:
Address _3 2- O � c5 , i-..ole- %dP.I,j CXr. , Apt 101
Legal D ,scription: The Sands -Section 1-Phase 1 BLDG1- Apt 1104 (OR 1217-426; 3333-1450; 3790-485, 2054
Proper4�r Tax ID #: 1426-605-0004-000-3 Lot No.
Site PI I Name: Block No.
Projec Name:
Setba , ks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Sliding Glass Door
CONSTRUCTION INFORMATION:
Addit onal work to e nertormed under this permit —check all apply: S1 arm
HVAC _ Gas Tank ❑Gas Pi _ Shutters Windows/Doors
Piping
Electric 0 Plumbing Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq- Ft of Construction:
Costlpf Construction: $ / -00
S Ft. of First Floor: _
UtilitiesSewer Septic
Building Height:
O
'NER/LESSEE:
CONTRACTOR:
Na
a Mary Mcasknc
Name: DoV\ ; 161e,
Add
less: 3-Mg 5 , LA-kci//ew rc(o r'!/7 ��f
Company: Don Hinkle Construction, Inc
Address: r� c5 d V0
Cin
ity C -f�I T)eye_ State: F�
Zip
ode: 34949 Fax:
City: l State: FL
Ph
I
he No.
Zip Code: 34982 Fax: 772-467-1348
E-
all:
Phone No. 772-528-2249
Fill jn
II
fee simple Title Holder on next page (if different
E-Mail: donhinkle@bellsouth.net
State or County License: CGC036040
fro I the Owner listed above)
If volue of construction is $2500 or more, a RECORDED Notice of Commencement is required.
0
SUPP
WENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIG
ER ENGINEER:
X Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Addre
d @ s-, UJ 13
Address:
City:lp:�t_51'r
State:
City: State:
Zip:Phone 77Z
- 9F5— % R-EP�-
Zip: Phone:
FEE SI M PLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name Name:
Addre s: Address:
City: City:
Zip: Phone: Zip: Phone:
OW NE / CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify hat no work or installation has commenced prior to the issuance of a permit.
St. Lucie bounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is n conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structur . Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consi eration of the granting of this requested permit, I do hereby agree that I will, in ail respects, perform the work
in accor lIance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The foil wing building permit applications are exempt from undergoing a full concurrency review: room additions,
accesso structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARN NG TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro ements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor the first inspection. If you intend to obtain financing, consult with lender or an attorney before
rr nrinn .•inrli nr rcrnrrHno %tniir Alntirc of ('nmmonrPMPnf
l(2
Signa 'ure of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STA E OF FLORIDA
STATE OF FLORIDA
Sr
COU TY OF
COUNTY OF
The f - rgoing instrument was acknowledged before me
this day of ,20by
The IpTing instrument was acknowledged efore me
thisday of 20A by
a Nme of making statement
person
Name of person making statement
Pers I nally Known OR Produced Identification
Personally Known OR Produced Identification
Typ of Identification
Type of Identification
Pro ced
Produced
54�L/'
(Sig ature of Notary Public- State of Florida)
(Si ature of Notary Public- State o lorida )
Co mission No. (Seal)
Commission No. .•My.ek'C•., MICHELE �. _ 2O
W COMMIS ION # GG 192725
EXPIRES: April 13, 2022
`'f op•'' blicUrWORY 1s
R IEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
I
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DA E
RE, EIVED
DA E
COMPLETED
Rev.8/2/17