HomeMy WebLinkAboutBuilding Permit ApplicationDESIGNER/ENGINEER:
Name:_
Address:
City: _
Zip:
Phon
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
x Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Address:
State: City: State:
Zip: Phone:
Not Applicable
BONDING COMPANY:
Name:
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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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Confrractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF STLUCIE
The forgoing instrument was acknowledgeeefore me
this 25 day of OCTOBER - 20by
DENVER MILLER
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary)Public- State of Florida )
} t rnY ^oo�, TIFFANY METZ
Commission No %aI)Commission #GG
N, o� Expires April 26,
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Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF ST LUCIE
The forgoing instrument was acknowled egbefore me
this 25 day of OCTOBER 20_M by
DENVER MILLER
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary PublicN State of Florida )kJ
, TIFFANY METZGER
Eommission No c:;3Jegb)mmission#GG3561
8
i`
-fExpires April 26, 2022
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DATE
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Rev. 2/7/19
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/25/19
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 TYPE: GARAGE DOOR
Address: 4307 THOUSAND PINE DR
Property Tax ID #: 2430-500-0012-000-9
Site Plan Name:
Project Name:
REPLACE 16X7 GARAGE DOOR
FL # 16546.4
Lot No. 12
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 1959.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name WILLIAM MISCH
Address:4307 THOUSAND PINE DR
City: FORT PIERCE State: EL
Zip Code: 34981 Fax:
Phone No. 772-618-5111
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
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.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.