HomeMy WebLinkAboutBuilding Permit ApplicaitonALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/7/18
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
Address: 10657 PINE CONE LN
Legal Description: PINE HOLLOW
Property Tax ID #: 2321-801-0016-000-6
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
REPLACE 16X8 AND 8X8 GARAGE DOORS
Left Side:
Lot No. 16
Block No.
Aaaitionai worK to De errormea unaer ims permit — cnecK au n apply:
HVAC _ Gas Tank E]Gas Piping _ Shutters Windows/Doors
❑ Electric ❑ Plumbing ❑ Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 3�. Utilities:Sewer Septic Building Height:
Name CHELSEA KOBLEGARD
Address: 10657 PINE CONE LN
City: FORT PIERCE State: FL
Zip Code: 34945 Fax:
Phone No. 772-216-2843
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: DENVER MILLER
Company: D & D GARAGE DOORS PSL
Address: 435 NW ENTERPRISE DR
Roof pitch
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax:
Phone No. 772-460-7630
E -Mail: TIFFANY@DDGARAGEDOORSPSL.COM
State or County License: 19007
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: __�fNot Applicable
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
State:
_o Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
SUPERVISOR
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
\6Not Applicable
Address:
COUNTER
City:
REVIEW
Zip: Phone:
REVIEW
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ,'mac COUNTY OFS-�-
The forgoing instrument was acknowledged before me
this I day of 20i$ by
Name of person making statement
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
(Signature of Notary PubliOState of Florida )
i otrR� p�e�, TIR
Commission No. COMM"
N� o� Expires
FLOP Bonded Tiw E
The forgoing instrufnent was acknowledgggd before me
this —1 day of \,ec e.<- , 20 \� by
Name of person making statement
Personally Known l/ OR Produced Identification
Type of Identification
Produced
(Signature of Notary Publics State of Florida )
N SUIT u� o'0y?tle, TIFFANY SUIT
#U09Wgion No��Q� Id -l* eal)COmmission#GG 1f
rte 26, 2022 N1 of Expires Aprfl 26, 2(
Ie(Not2(y swoer, 9l` OF FLOP Bonded TNN Budget Notaty:
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17