HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r( 0 P-19 Permit Number:
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Building Permit Application Rc.$iVza
Planning and Development Services
Building and Code Regulation Division ��y I 0 70
2300 Virginia Avenue,Fort Pierce FL 34982 pert%tong 19
Phone: (772)462-1553 Fax:.(772)462-1578 Commercial Res1dtit0ar , nt
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PERMIT APPLICATION FOR: Window/door ,
PROPOSED LOCA ION. .,..
Address: 4914 Paleo Pines Cir Fort Pierce, FL 34951
Legal Description: HOLIDAY PINES S/D-PHASE II-B-LOT 300(MAP 13/13N)(OR 808-863: 1329-2344; 3211-1695:4072-580)
Property Tax ID#: 1312-801-0103-000-2 Lot No.300
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
Replace 1 door size for size (Non -Impact Glass) [NOA 17-0504.06]
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit check all ha apply: l
HVAC —Gas Tank Gas Piping _Shutters Q Windows/Doors
ElElectric Plumbing Sprinklers _Generator _Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 4180 Utilities: I _Sewer _Septic Building Height:
OWNER/LESSEE ',CONTRACTOR`= ,.
Name Steven Phillippe Name: Roberto Sanchez
Address:4914 Paleo Pines Cir Company: The Home Depot
City: Port Saint Lucie State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34951 Fax: City: Fort Lauderdale State:FL
Phone No.772-519-0569 Zip Code: 33309 Fax:
E-Mail: Phone No. (754)224-2010
Fill in fee simple Title Holder on next page(if different E-Mail: ashley.raines@expeditepermit.com
from the Owner listed above) State or County License: CGC1522717
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENO,Oco s-wgogT o LI N4LAw INFogm-AR N� ; • v b � `:
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: Name: _
Address: Address:
City: I 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 represu
sentation that is granting a permit will authorize the permit holder to build thesubject 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 areexempt 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.
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Signature of Owner/Agent/Lessee Signature of Contractor/ ice se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF St Luae
The forgo' g instrumen as acknowledged before The f oing instr ent was acknowledgged before me
me this day of 20 _by this day of 201'S,,by
Roberto Sanchez Roberto Sanchez
(Name of person . iwledging) _ (Name of p1erson ackn• . -dging)
A 1
(Signature of Notary Public-State of Florida) (Signature of •,:tary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) ,, Commission No. (Segj n1ey Raines
-,, Ashley Raines T� ; p
. NOTARY PUBLIC
;r ,: �NOTARY PUB'IC "' STATC OF FLORIDA
`•-%�`s i A rt Of=FLORID " 235RID
Revised 07/15/2014
`. ''Comm- GG233648 ;-:i. �Comm GG
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Exoires7/5/2022 �z Exp
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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