HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/13/17 Permit Number:
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
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a
Address: 500 PAUROTIS LN
Legal Description: PALM GROVE
Property Tax ID #: 3410-503-0230-000-3 Lot No. 20
Site Plan Name: Block No. H
Project Name:
Setbacks Front Back: Right Side: Left Side:
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TEAR OUT AND REPLACE 16X7 GARAGE DOOR
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Additionalworkto e e orme under this permit a apply:
❑HVAC Gas Tank Gas Piping _ Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: SgFtj of First Floor:
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Cost of Construction: $ 2075.00 Utilities: I—J Sewer Septic Building Height:
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Name HAROLD BRUNSON
Name: DENVER MILLER
Address: 500 PAUROTIS LN
Company: D & D GARAGE DOORS PSL
City: FORT PIERCE State: FIL
Address: 435 NW ENTERPRISE DR
City: PORT ST LUCIE State: FL
Zip Code: 34982 Fax:
Phone No. 772-464-0022
Zip Code: 34986 Fax:
E -Mail:
Phone No. 772-460-7630
Fill in fee simple Title Holder on next page I if different
E -Mail: TIFFANY@DDGARAGEDOORSPSL.COM
State or County License: 19007
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
6,4
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
DESIGNER/ENGINEER:
x Not Applicable
MORTGAGE COMPANY:
X Not Applicable
Name:
REVIEW
Name:
REVIEW
Address:
REVIEW
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 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
COmmencina worK or recording vour Ivoiice or (-ommencemenL.
Signature of Owner Le be/Contractor as Agent for Owner Signa�t e�of Confractor/Licens` Holder
STATE OF FLORIDA++ STATE OF FLORID .
COUNTY OF 1 �.c �.� COUNTY OF a�
The f ping instru ent was cknowledged before me The forgoing inst ment was acknowledged before me
this day of �\ 20 f )by this ��day of 20 _0 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- Stale of Florida )
Personally Known 11'el OR Produced Identification
Type of Identification Produced
Commission No.��✓,����� SPA-`P�(' eal) TiFFAPiYA.LE-E
* EXPiRES A :'
Revised 07/15/2014
(Signature of Notary Public- State"of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
n No. PAY*Y��Seal) TIFFANYA.LEE.
* MY C1S SIOF 101414
Bonbd Tihru Gud:Vh y ;_;, vs
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS