HomeMy WebLinkAboutWINDOW/DOOR INSTALLATION COMMERCIAL OMPLETEDTOR 1.4 '�-TO'BEACCEP-T.ED'.L,-:',,----� '"',-,"
-ALL-APPLICABLE-IN -APPLICAT iN
INFO
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Peri-nit Nurner
RECER � 2016
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Uldfillig Pdr' 'm"it 1hation
Planning and Development Services
Building and Code Regulation Division-
'2300 Avenue,Fort Pierce k34982 - -
Phone:,(772)461-1553:_Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Oil
Address: nil n
Legal Description: L.,30 lod AQ I IQ r- VNIOS co,n&n
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Property Tax ID#: \' Lot No.
Site Plan Name: Block No.
Project Name: �n?jnc�
Setbacks Front.: Back: Right Side: Left Side:
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Additional work toTier ormed under this permit-check all apply: E
0 HVAC Gas Tank E]Gas Piping Shutters awindows/Doors
11 Electric El Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft of First Floor:
Cost of Construction:.$' a? # ,2 00 .9 Utilities.Cn Sewell Septic Building Height:
Name ileac o b,s e in Name- 111V_91JF=4 C_V_1nkA4Cn,
Aciclress: :�qqn -9,pee-e r 223-8 .
- Company.
City: R e nN ?Q o c- State: Address:
Zip Code: 3 WQ&7 Fax: city: I State.-F
Phone No. Zi
Q `-15g Fax . -I'l-2-S52
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Zip Code:
E-Mail: Phone Np.,�)(a 7L13—
-Fill in fee simple Title Holder on next page (if different E!tmail:
from the Ownerlisted above) State or County License:
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If value of construction.is$2500 or more,a RECORDED Notice Of tonimenceme'ht 19 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:
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 thepermit 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
comm ding your Notice of Commencement.
s
_Signature of Owner Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORI A STATE OFFL ' I ^
COUNTY OF COUNTY OF S6 )
Th r oing in ment was acknowled before me The for oing instrument was acknowledged before me
t day of 20LWy this25day of 20 Jtp by
(Name of person acknowledging) (Name of'person acknowledging)
V10- C/A (M PM JO
Ignature of Notary Publi State of Florida) gna i of Nota7 -
Personally
tate of Florida)
Known OR Produced Identification Personally KnownOR Produced Identification
Type of Identification Produced •fication Produced
�7. MEDS ARMENfO _
Commission No. ?S �(Se Ing MY COMMIS IOC Iffffi 16on o. 1
-*' EXPIRES•D cember 28,
PubiicUnderwMef5 :n4ti'RJ°' •• MELISAARMENTO
' `F''o?• Banded Thru No _+ t
;•° MYCOMM
EXPIRES:December 28,2016
Revised 07/15/2014 ;Pf;Vie^ Bonded Thru Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS