HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/29/2015 Permit Number:0�15. 1
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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: Building
PROPOSED IMPROVEMENT;LOCATION:
Address: 5910 Birch Drive Ft. Pierce, FI 34982
Legal Description: Parcel #: 3402-609-0610-000-1
Unit-08 Blk: 69 Lot: 4
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF:WORK-
Re move
ORKRemove and Install a 16x7 DAB Garage Door in the front of the house.
CONSTRUCTION.I N F_ORMATION:
AcIclitional work to be nprformedunder t is perm it—c ec a appy:
❑HVAC Gas Tank Gas Piping Shutters Windows/Doors
O _
Electric Plumbing Sprinklers Generator F]Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ Utilities Sewer OSeptic Building Height:
OWNER/LESSEE;; CONTRACTOR:
Name C l me: ssac orla
Address: r=rec arage oors nc.
city: a State:_ Address:
SaintUCIe FL
macedo v
Zip Code: City: 34983 State:
Phone No. 5�- 9ag - 0 y Ll `3 Zip Code: Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: lsaac. oris(Oya oo.com
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
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.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA J r STATE OF FLORIDA '
COUNTY OF COUNTY OF QCI,P
The fo oing ins ument was acknowledged fore me The for oing instrument as acknowledged before me
this Mday of 20 by this if day of 20 LGby
(Name of person acknowledging) (Name of person acknowledging)
aj�\4 M i
eN 1�\
(Signature of Notary Publ'c- tate of Florida) (Signature Public-State of Florida)
Personally Known OR Produced Id of ation Personal) `.,•spa m. O d(dent' ion
Type of I u d Type of I t Prty GfLA
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cornr�-S 1
�.•tpar°oa..,� ANGELA M HU
°���u°a�; MY COMMMIss/oq .tate Of
Commiss tt o. Nota pik-State a �jal) Commi FF 34 0661/
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' • '= Commission tY FF 234730 �ttvoo9htV �taY27•.20ty
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS