HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/05/2017 Permit Number: d \6
RECEI!l-1 Jul 10 17
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•
PRCPt�SED ENT"OW",
Address: 4715 Murtle Dr.fort pierce,fl.34982
Legal Description: Indian River Estates-Unit 07-131k 39 Lot 20(map 34/02n)(OR 2837-414)
Property Tax ID#:"3402-608-0075-000-5 Lot No.20
Site Plan Name: Indian River Estates Block No. 39
Project Name: Dykes
Setbacks Front Back: Right Side: Left Side:
DETAILED ( SCRIPTIOi110F WORK '' gi
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e, 1 �C""?,a,w,,,,, _-_>, ..... .,". 1•",` �a'. Y.,.:�n ., i � S 'r"2 :', `.,x i�, f"�w' `Y C<a._
Replace 16 x 7 Garage door Size For Size
CC STRt1GTItN INFaRMTIdiU.
Additional work toe e orme under this permit-check a appy:
HVAC Ei Gas Tank []Gas Piping _Shutters ✓Q Windows/Doors
11 Electric 11Plumbing Sprinklers E Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1,574.00 Utilities: Sewer Septic Building Height:
77
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t71 (NERf LESSEEC3NTRACTOR..
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Name James Dykes Name: Mitchell O.Pierce
Address:4715 Murtle Dr. Company: Quality Garage Door Services
City: Ft. Pierce State:_ Address: 116 S. Park Ave -
Zip Code: 34982 Fax: City: Titusville State:Fl
Phone No.772-323-3856 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.
SUPPLEMENTALCON LIEN LA1N INEC?RMATICIN
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 propVfng'
y. AN otice of Commencement must be recorded and posted on the jobsite
before the first inspectio . u intend to obtain financing, consult with len de an attorney before
commencingr Corour Notice of Commencement.
s
Sigrfati ire of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA—
CO U NTY
LORIDA—COUNTY OF SN _ t_Uc COUNTY OF eyut r d
The forgoing instrument was acknowledged before me The f Wing instrument was acknowledged before me
thisk b day of ��dc^n 20 Lby this day ofP 20 La by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu c-State of Florida) (Si ure of NotaryPub'e State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced L Type of Identification Produced
Commission No. —�S��o SoN#�6 02o mmission Noce-
Commission
LISA DALL
r=gti`9� '• WpR S:DgCPp bwV;�OrXOe =` `c MY COMMISSION#GG024256
EXPIRES August 24,2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS