HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� ), Permit Number:
RECEI VE-D JAN 10"2u17
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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: Window/door
:PR QPOSED CMPROVENIENT LCCATIaN
Address: 5802 Fort Pierce Blvd.
Legal Description: Lakewood Park-Unit 5 BLK 40 Lot 1(map 13/11 N)(or 541-1067;3234-2559;3517-539)
Property Tax ID#: 1301-605-0001-000-1 Lot No.1
Site Plan Name: Robert Porter Block No. 40
Project Name: Porter
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION"OF'WO.
Replace 16 x 7 Garage door"size for size
CO,NSTRUCTI,fJN,INFQRII%IAdditional ATIOV
work to b
Gasrtormed Tank
under tIS permit Gas Piping—check a
ll apply:
E]HVAC ❑ p Shutters Windows/Doors
✓ Wi "
_ ❑
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2.303.00 Utilities: Sewer❑Septic Building Height:
NOUVNER/LESSEE CQIVTRACTOR
Name Ronald Porter Name: Mitchell Pierce
Address:5802 Fort Pierce Blvd. Company: Quality Garage Door Services
City: Ft. Pierce State:_ Address: 116 S. Park Ave
Zip Code: 34951 Fax: City: Titusville State:FI
Phone No.772-713-2411 Zip Code: 32796 Fax: 321-264-7416
E-Mail: Phone No. 321-264-6399
Fill in fee simple Title Holder on next page(if different E-Mail: Qualitygaragedoorservices@yahoo.com
from the Owner listed above) State or County License: CRC1329903
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION I: EN I.AW INF;C3RMATlQ1�
z
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: NotApplicable
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. Pu intend to obtain financing, consult with lender or ttorney before
commencingrec n our Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FL IDA
COUNTY OF_Z_�k, 1-y C\"Z, COUNTY OF �eyn��
The forgoing instrument was acknowledged before me The forg�Ring instrument was acknowledged before me
this \6 day of 5A IN 20 �by this c 'day of bl-_ be/ 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary blic-State of Florida) (Si nature of Notary Public-State of Florida)
Personally Known OR Produced I Personally Known V OR Produced Identification
Type of Identificati IF G Type of Identification Produced
``,,•Y�11.•••
Commission No. MV COMMISSION Gs2020 Commission No�7�C)��.25(o
,• .••, EXPIRE� 023
��In tars (Seal)
%�r p- ondgd ThN Notary publlr Undsr'g
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ALISA A TINDALL
Revised 07/15/2014
MY COMMISSION M GG024256
REVIEWS FRONT ZONING SUPERVISOR PLANS VEG OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS