HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE I FO MU TBE OMPLETED FOR APPLICATION TO BE ACCEPTED ( y�
Date: Permit Number: I C/ `�
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 X
PERMIT APPLICATION FOR: Window/door
PRQPOSED 1,MPRQIIEMENT�LOCATIONNt
.-
Address: 'q 6Vll:Per— T�-1
Legal Description: M L)r4-c- (I-gV-10 aA+iey G U 10 — Q 1)14- 7-W 0 /'9/
( br ' 34SS— M (P )
Property Tax ID#: 1 3 3 'f —s U 2 `y6 7-a 66 U ' j Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: _Left Side:
®ETAILED QESCRIPTION OF#WORK
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CONSTRUCTION INFORMATIONS
Additional work to be nertormed under this permit-check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
LJ Electric 0 Plumbing ❑Sprinklers Generator tJ Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ L1 3 Utilities: Sewer OSeptic Building Height:
C)W.NER/LE{SSEE ¢' v CONTR'ACTQR
_ r, q � .-
Name-Wol PQM/r)A01 T �?J 11G� Name:.Jack•B;.Melton
Address: p .i1✓�.�-h }� ,C.ompany::Garage poor dales, Inc
City: V4 qL State: Address: 2807'Okeechobee Road '
Zip Code: Q J S�eFax: City: Fort Pierce State:FL
Phone No._-112L 3`5q'10-+4 Zip Code: 34947 Fax: (772)461-8719
E-Mail: Phone No. (772)461-0729
Fill in fee simple Title Holder on next page (if different E-Mail: kat@garagedoorsales.net
from the Owner listed above) State or County License: County Cert: 4526_
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required "
SUPPLEMENTALA
L CONSTRUCTION LIEN W INFORMATION:
DESIGN
4.: _ A, ,... .,.... . ,.__,., •.a.,., . . , ..., ., ,..
NER/ENGINEER• x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
i iTSi nature of OwW/A ent/ ssee i atur o Contract /Licen a Ho der
SiATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S i- L.L(e,&,Q COUNTY OF St oae
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this—4—day of 20 is by this_�L day of ViSL 20-4rby
in y �47mQ IL Katherine V Roznak
(Name of person acknowledging) (Name of person acknowledging)
Y
Signature of Notary Public-State of FI rida) ( ignature of Notary Public-State of Florida)
Personally Known OC OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced N79,pe of Identification Produced mr~PjM-\ ^
y5 vy'q)�} ro KA 9ER11M v.11MAi
hi i �L�v yafP.:�
Commission No.T'F6'A0 NO O _ e
K. �57z" mission No. FFoaaoso r Seal OMMISSION 0FPQ99
4�Y ly 29EXPUZES 2017 EXPiRFS�:duly as,a0t9
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS